23Strands: “Medicine has been woeful in looking after women from the very beginning - 99% of drugs have been designed around men”
Health 10x alumni 23Strands are revolutionising women's healthcare starting with fertility
Thanks to Sydney healthtech startup 23Strands personalised medicine has never been closer.
The team is utilising whole genome sequencing and Artificial Intelligence to unlock the power of your genetic code to provide a more accurate pathway to better patient outcomes. In layperson’s terms, they’re developing an end-to-end platform that tests all your genes to work out which ones put you at risk of inherited disorders, cancer, and other diseases, and help your doctor create a specialised, personalised treatment plan.
We’ve all seen the ads for 23andMe or Ancestry.com offering genetic testing. But these consumer-facing tests are just scratching the surface of what’s possible according to 23Strands co-founder and CEO Mark Grosser. “We offer a clinical service while those consumer-grade panels do less than 0.1% of the genome which is the complete set of genes,” he tells UNSW Founders. “The best direct-to-consumer service we saw was 23andMe, out of the United States, who cover about 0.03% of your genetic makeup. We are analysing about 98-99% of the whole genome and the reason for this is its rapidly reducing cost and the quality of insights we can deliver from having the complete picture. This includes very rare variants that are quite hard to process.”
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Unlike their competitors, it’s not just ancestry and traits 23Strands are testing for, the health tech company is creating a revolutionary diagnostic tool providing doctors with personalised health pathways to vastly improve the health of women and improve reproductive health.
“It is surprising that we haven't seen anyone else doing this in the women’s health space. Our process looks at all of the clinical information, not just your blood work and the genetic testing results. We adjust the results to the person as opposed to trying to fit the person to the test. And that's where personalised and precision medicine comes in.”
23Strands co-founders Mark Grosser, Omer Ingber, Rob Mitreski, and Nick Devereaux
“We want to save lives,” Mark says. “The whole medical engine that [humans have] created has been woeful in looking after women from the very beginning. 99% of drugs have been designed around men and 100% of drugs have been designed for non-pregnant patients. This is an area where we feel we can have the biggest impact. Genomics is big, it's complex, it's super detailed, and we're not the only people looking at these problems. What we are driven to do here in Australia is build collaboration both locally and internationally to solve these women’s health issues and we are thrilled to be working with collaborative researchers in UNSW, UTS, Sydney University, and Monash University.”
23Strands provides next-generation platforms, genomics analysis technology, and deep Natural Language AI, combined in one. They take comprehensive clinical information including blood tests, family history, disease diagnosis, pathology, and pharmacology (which drugs work best for you). They then link this information and go out to real-world evidence to see which treatment approaches are ideal. “We process hundreds of thousands of journal articles,” Mark says. “We pull out the gene-disease links, pull out the drug-gene links and combine these with population health data that allows us to ask better questions out of the evidence, to narrow the journal articles down to the ones that will best help answer the questions we are asking. And then we also link what we term gold standard data sources. We are developing novel artificial intelligence methods to process the genomics, health record, and precision drug targets and to better find the answers we are looking for. We then deliver three main reports; a whole genome disease, pharmacology, and carrier screening reports. We deliver these on our Healthpath platform or directly into the Patient Management System already being used by the doctors.”
23Strands fills a gap for clinicians and researchers, delivering the whole genomics workflow from a treating doctor referral, the logistics of the blood draw through to the final delivery of their comprehensive reports. Currently in the pre-revenue stage, the startup is in the midst of raising a seed round to help take their products to a clinical setting in the next 18 months.
Mark and his co-founders Rob Mitreski, Omer Ingber, and Nick Devereaux pivoted to women’s health while taking part in UNSW Founders Health 10x Accelerator in 2020. “We pivoted completely because of Health 10x,” Mark explains. “We’ve found passion and commercial alignment with solving women’s health issues and that was a direct impact of Health 10x. Through the advisor network, we were introduced to Dr. Vinayak Smith who suggested we consider women's health and reproductive health. It made so much sense and was a very quick yes. That has provided us with a clear commercialisation strategy that makes market and future development sense.”
UNSW Founders 10x Accelerators 2020 Cohort social drinks (Mark bottom right)
Dr. Smith now works closely with 23Strands in his role as Lead of 23Strands’ Women’s Health practice and also in his role as Head of New Ventures at Virtus Health, a Health 10x partner. “This delivers on helping solve the complex challenges of a woman’s healthcare journey through her lifetime, we're really looking at young adulthood through to motherhood in the path of a woman through her lifetime,”
Mark details: “A big part of this is unexplained infertility testing, looking at the really hard-to-solve cases. We partnered up with Virtus because around 15% of the people who go through IVF have been diagnosed with Idiopathic infertility, that’s about 10,000 couples a year in Australia.”
Virtus Health is a leading provider of assisted reproductive technology, specialist pathology, and day hospital services. “IVF is a great place we can bring whole genome sequencing to,” Mark says. “These women are going through these very expensive IVF cycles and are failing multiple times. So we aim to get them rapidly sequenced, give their doctors a detailed understanding of their genomic health and provide insights into why they may be having problems conceiving. This then allows us to also provide expanded carrier screening but also gives a foundation for testing their child. The first of these childhood screens happens during pregnancy via a non-invasive prenatal test (NIPT), which is a test for circulating fetal cell health from a sample from the mum's blood. Once the IVF is successful and the embryo is implanted properly the placenta starts to leak DNA from the baby into the mother's bloodstream. In the future, we aim to then compare the mother's genome with the baby's and identify in-utero major diseases. It's an area that is still cutting-edge. Ultimately what we're looking for are cells that don't fit the mother's cells and then sequence them, the future is the whole genome.”
While 23Strands is not currently commercially selling its reports, they are rapidly moving toward regulatory and commercial launch. At this time anyone interested in accessing their solution can volunteer to be a part of a study with IVF Australia, Virtus Health, and 23Strands.
“You can enroll in our study and you and your partner will be whole genome sequenced for free,” Mark explains. “You won't directly get the report as this is a study under ethics and because we want to make sure that we're providing the doctors the most accurate information in the easiest-to-understand way. But you're able to work with the clinical team and the research team within IVF Australia and 23Strands. We are working on another ethics-driven project which will be more focused on rare diseases rather than on Idiopathic infertility. So it's focused on the screening of parents and their risk of passing genetic diseases to their children but using whole genome sequencing. We are working to get commercial reports to doctors in 2024.”
