Oriana Papin-Zoghbi, "AOA Dx"

AOA Dx Founder, Oriana-Papin-Zoghbi

Mostly diagnosed in late stages, ovarian cancer is a silent killer of women. Oriana Papin-Zoghbi of AOA Dx aims to defeat this threat. Fresh out of Y Combinator, the team is making impressive headway in commercializing a promising technology from McGill University.

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Highlights:

  • Sal Introduces Sponsors, Purdue University Entrepreneurship & Peter Fasse, Patent Attorney

  • Sal Daher, CFA Welcomes Oriana Papin-Zoghbi of AOA Dx to the Podcast

  • Ovarian Cancer Is a Silent Killer of Women

  • “None of us on the founding team were originally scientists... We needed to really create a partnership.”

  • Partnered with Professor Uri Saragovi of McGill University

  • “...80% of cases being diagnosed when they're already Stage III and IV.”

  • Professor Saragovi’s Approach Is Using Certain Glycolipids in the Patient’s Blood as a Marker of the Presence of Ovarian Cancer

  • AOA Dx Supported by a Retrospective Study – Reached 95% Accuracy

  • Sal Daher, CFA Makes the Case for Re-Skilling Angels Used to Investing in Software into Life Science Investors

  • “We expect to be on the market in the US by 2025. Another four years out from here.”

  • AOA Dx Is Developing a Platform for Early Detection of Other Diseases as Well

  • Is AOA Dx Considering a Strategic Collaboration?

  • A Good Attitude Towards Strategic Collaboration

  • “...I can make the case for life sciences and that is where we are today is at the cusp of innovation, or medical innovation in the life sciences, this is truly just the beginning.”

  • “...our ability to beat cancer or Alzheimer's or other types of diseases. It's that impact investment that is going to make a difference 30 years to come from now...”

  • “I fully attest to the value Y Combinator gave us...”

  • “...TBD Angels I worked specifically with, or closest I should say, with Yael and with Vicky was, how quick and transparent all of our communication was.”

  • “...for anybody that is interested in the art of persuasion, I very much recommend reading about Robert Cialdini and his books...”

ANGEL INVEST BOSTON IS SPONSORED BY:


Transcript of, “AOA Dx”

Guest: Oriana Papin-Zoghbi, Founder

Sal Introduces Sponsors, Purdue University Entrepreneurship & Peter Fasse, Patent Attorney

Sal Daher: This podcast is brought to you by Purdue University Entrepreneurship, and by Peter Fasse, attorney at Fish and Richardson. Welcome to Angel Invest Boston, conversations with Boston's most interesting founders and angels. Today, we are really privileged to welcome Oriana Papin-Zoghbi, founder of AOA Dx. Welcome, Oriana.

Sal Daher, CFA Welcomes Oriana Papin-Zoghbi of AOA Dx to the Podcast

Oriana Papin-Zoghbi: Thank you for having me.

Sal Daher: This is tremendous. Oriana is doing an amazing job as the founder of a hugely consequential company, in which I am an investor, and that company AOA Dx is addressing a terrible problem. It is addressing the problem of a silent killer of women, which is ovarian cancer. I'm going to have Oriana tell the story of how this tremendously consequential startup came about. Oriana, what's the founding story of AOA Dx?

Ovarian Cancer Is a Silent Killer of Women

Oriana Papin-Zoghbi: My co-founders and I have been working together now for the last decade. We've been privileged enough to be a part of two other women's health-focused diagnostic startups, both also built out of Boston with the goal to really bring to market, disruptive technologies that help solve problems that disproportionately affect women. 2018, the last company that we were a part of had a really nice exit. The three of us had got back together again and said, "Okay, well, where else is there a huge need? Where else is there a gap? Where else do we lack diagnostic testing and an area that can serve women?" We went on the hunt for about a year. We looked into a variety of different diseases, ranging from endometriosis to C-sections, ovarian cancer.

“None of us on the founding team were originally scientists... We needed to really create a partnership.”

The more we learned, the more we saw that, wow, there's a lot of needs in women's health. Then we started to pair that up with, where was there research? Where was there innovation, and how could we match the two? None of us on the founding team were originally scientists, it's not that we had this idea and we said, "We're going to go to the lab and develop something." We needed to really create a partnership. We were coming at it from, where are the needs in women's health, and then who is studying this? Where are there patents? Where are their publications? How could we connect the two? After about a year of diligencing a number of different ideas and investigators and innovators, we met Professor Saragovi, who's a renowned academic at McGill University. He was working on this really new approach on diagnosing cancer from blood. He had specifically been looking at ovarian cancer, which obviously, very much piqued our interest. That was essentially the beginning of our partnership.

Partnered with Professor Uri Saragovi of McGill University

Sal Daher: Excellent. How does the technology work? How is it that you are finding indications of ovarian cancer early enough? Ovarian cancer is called the silent killer because frequently it's hard to diagnose, symptoms are confused for other things. Then all of a sudden when it's diagnosed, it's progressed too far to be excised. Could you explain to me how it is that you're getting the signals about ovarian cancer?

“...80% of cases being diagnosed when they're already Stage III and IV.”

Oriana Papin-Zoghbi: That's exactly right. Unfortunately, the symptoms of ovarian cancer are not specific. There are things such as bloating, abdominal pain, changes in bowel movements, and there is no diagnostic test on the market today. As you mentioned, this leads to about 80% of cases being diagnosed when they're already Stage III and IV. 

Sal Daher: Horrible!

Oriana Papin-Zoghbi: What we're doing differently is actually identifying certain biomarkers in the blood that originate from the tissue and that are specific to ovarian cancer but also sensitive and detectable starting in Stages I and II. The family of biomarkers are known as glycolipids. This is where the innovation came from Professor Saragovi’s lab, which is these markers have never been used before. They've never been able to be worked on from a diagnostic purpose. That's where we're coming in. We're developing a blood test that specifically detect these markers that we know are originating from the ovarian cancer tumor tissue, and that we also now know are present in Stage I and II, just as much as in Stage III and IV. Now, when a woman has these symptoms, she could go to the doctor, she could get tested with a blood test, and accurately know, does she, or does she not have ovarian cancer before it's too late?

Sal Daher: These glycolipids are detected in what way?

Professor Saragovi’s Approach Is Using Certain Glycolipids in the Patient’s Blood as a Marker of the Presence of Ovarian Cancer

Oriana Papin-Zoghbi: We're using a technology called ELISA [enzyme-linked immunosorbent assay]. Essentially, think of it like a jigsaw puzzle. It's an antibody technology where we've created antibodies that bind specifically to the targets that we're going after in a perfect jigsaw that allows us to detect and quantify the levels of these markers in the sample, allowing us then to use our proprietary algorithm to distinguish ovarian cancer versus non-ovarian cancer.

Sal Daher: Do you know if ovarian cancers give off circulating tumor cells?

Oriana Papin-Zoghbi: From what we've seen in the research so far they do not. This is why it's been very difficult to use next-generation sequencing or other technologies to be able to find markers for ovarian cancer.

Sal Daher: Very interesting. What's the support that you have so far that your approach makes sense?

AOA Dx Supported by a Retrospective Study – Reached 95% Accuracy

Oriana Papin-Zoghbi: We've just completed a very large Biobank study with over 600 women enrolled into the study, and across the study, we looked at women with ovarian cancer across all four stages. We also looked at healthy normal controls as well as women that have other gynecological conditions, and other cancers that present similarly to ovarian cancer. Because of course, we wanted to know, can we distinguish between them? In that study, we achieved over 95% overall accuracy to be able to diagnose ovarian cancer.

Sal Daher: This is a retrospective study.

Oriana Papin-Zoghbi: That's exactly right.

Sal Daher: You're looking at people after they're diagnosed and you're going back and you're looking for the marker, and then you're trying to find--

Oriana Papin-Zoghbi: That's exactly right.

AOA Dx Supported by a Retrospective Study – Reached 95% Accuracy

Sal Daher: Right. Are you going to need before this becomes approved for clinical diagnostic - what's the FDA approval path for the diagnostic?

Oriana Papin-Zoghbi: For our case particularly we are going to be pursuing a 510k De Novo approval. Essentially that's a class two and we will be required to do a prospective clinical trial as well once our full IVD assay is finalized. We will be recruiting patients into our own clinical study here in the US.

Sal Daher: IVD, In Vitro Diagnostic.

Oriana Papin-Zoghbi: That's exactly right.

Sal Daher, CFA Makes the Case for Re-Skilling Angels Used to Investing in Software into Life Science Investors

Sal Daher: Oriana, by the way, this may be of interest to you. I'm engaged in a mission of helping angels who are investors in software startups. Angel investing has grown around software eating the world over the last 10 years. I'm trying to help angels become more focused on investing in the life sciences. I've converted over to that because of a bunch of life science companies that I'm involved with. I'm on the board right now of a rare cell company that is working on diagnostics, for example, triple-negative breast cancer-

Oriana Papin-Zoghbi: Wow.

Sal Daher: -using circulating tumor cells. There's a very major study that was published in JAMA Oncology last year that used their technology to significantly improve the prediction, the ability to predict whether or not this horrible breast cancer will recur after treatment. That's why I made this a little detail. I want to explain to angel investors that there's a lot to be done in the life sciences that can be funded with angel funding and you're an example of that. A very good example of that.

Oriana Papin-Zoghbi: Yes.

Sal Daher: How long do you think it would be when you complete your Class II, 510k approval?

“We expect to be on the market in the US by 2025. Another four years out from here.”

Oriana Papin-Zoghbi: We expect to be on the market in the US by 2025. Another four years out from here.

Sal Daher: What kind of capital are you going to need to raise in order to achieve that?

Oriana Papin-Zoghbi: One thing that I do want to mention which ties into the capital is our first test that we're coming to market with is for the diagnosis of ovarian cancer. The markers that we are working with are actually-- the class of markers I should say, the family expands into other cancers as well. We're actually developing a platform starting with ovarian cancer, but we're also doing more discovery and research in other cancers as well, where there is a need for early detection and it doesn't exist today.

AOA Dx Is Developing a Platform for Early Detection of Other Diseases as Well

Overall, our goal over the next five years is to bring to market an assay for ovarian cancer while also doing research and discovery and other cancers. Overall, we're looking for that mission I would say, we're looking at a capital of investment of about $30 million to be able to bring to market the ovarian cancer assay while also continuing to do discovery and build out our platform.

Sal Daher: Are you thinking about strategic collaboration to speed up your process?

Is AOA Dx Considering a Strategic Collaboration?

Oriana Papin-Zoghbi: We are. I have already had a number of discussions with some really great diagnostic global companies on how to partner whether it is from a development perspective, a clinical trial perspective, or eventually a commercialization perspective. That's certainly on our radar. I would say it's not an active goal for right now. Our active goal right now is to build, to really, really build something of value, and then we'll go from there.

A Good Attitude Towards Strategic Collaboration

Sal Daher: Actually, what you're saying I think is really wise that you should be focusing on maturing your technology and taking it forward but opportunistically, entertaining conversations with potential strategic players. Not having the attitude of, "Okay. This strategic player is going to come in and float our boat." I think that your attitude is very wise because opportunistically, you could come across that, and it could make an enormous difference. I compare that to-- Are you familiar with SQZ Biotech?

Oriana Papin-Zoghbi: I am not.

Sal Daher: SQZ Biotech, S-Q-Z Biotech, is a microfluidics company. I've focused on microfluidics. What they do is they have a technology for transfection, cell transformation, which has, among other things, proven to be very effective at producing cell therapies. I was an early investor. I put together the angel round for SQZ Biotech. They were basically put on the map by a collaboration with Roche. Very recently, their stock popped like 11% because they just announced results that will take them one more step in getting one more payment from Roche.

They were working very hard to develop along the track. Serendipitously, they got the collaboration with Roche. It could have been two years later. I think you're doing the right thing. Very easily it could happen that as you get some more interesting results that you could get a strategic interested in you, then that will tremendously accelerate the pace of development of your diagnostic.

Oriana Papin-Zoghbi: That's exactly right. That's very much the attitude that we have is truly to build this technology, honestly, to be a standalone company and to bring this to market. If there is an opportunistic conversation with the strategic that aligns with the goals that allows us to essentially expedite our process but still very much aligned with what we're aiming to do, then that makes perfect sense.

In our experience as well, the three of us, we've played out both models. We've done the model where we built a company, brought the product to market, got reimbursement, sold for a number of years, and then partnered with a strategic. We've also done the model where we essentially brought on a strategic from our first round with the intent to sell right upon FDA approval and then sold it right upon FDA approval.

Sal Daher: Let's get into those companies. Let's step back here.

Oriana Papin-Zoghbi: Go back into time now, 10 years back.

Sal Daher: Let's go back into time. Let's wrap up a little bit AOA and assess that. 

Sal Daher: Let's go back a little bit 10 years ago. [laughs] Tell me about the other companies you're involved with.

Oriana Papin-Zoghbi: I would say this is quite unique. Our three co-founders, Anna, Alex, and Oriana. If you haven't picked it up already, that's where AOA comes from Anna, Oriana, Alex.

[laughter]

Oriana Papin-Zoghbi: Sometimes, they still get the question, and I'm like, "We're not that unique, but okay." [laughs]

Sal Daher: Tell me the name of your co-founders again because they're very important in your life because you're founding a company with them again.

Oriana Papin-Zoghbi: There's Anna Jeter and Alex Fisher. Don't tell my husband, but they're my better halves.

[laughter]

Oriana Papin-Zoghbi: 1/3, 1/3, 1/3, 1/3. [laughs]

Sal Daher: I have a better third too, but there's only one better third of mine, and she's-- Anyway, take a guess. [laughs] Can you tell me a little bit of what they bring to the equation, your different founders? What is it that they bring?

Oriana Papin-Zoghbi: I would say above all the three of us challenge each other in a way that makes AOA better every single day. That is because all three of us are experts in certain areas. I come from a very strong go-to-market commercialization sales background. Anna comes to us with a much stronger clinical and regulatory background. Alex comes to us from an operational background. The three of us have different expertise that really complements each other.

We have personalities that are so distinct that also allows us to challenge each other in a way that helps us grow because we have this 10 years of history of having worked together, of having done two other companies together, of having trusted each other throughout the journey that now when either one of my co-founders say, "I want to challenge you. I want to really think hard about this. Are we doing this in the best way possible?" Then I don't get offended. I don't get upset. I say, "Okay. Let's really dive into that."

Which can be hard sometimes as an individual. Put your ego aside and really think about everything together. We have that. When investors have seen us pitch together, the one really common note that our investors say at the end is, "Wow, the dynamic you guys have. The dynamic you guys have." It sounds cheesy, but we have the ability to finish each other's sentences. We know things so well amongst the three of us that it flows so nicely as a team.

Sal Daher: That is awesome. I'm just thinking some of the people who've been on this podcast. Todd Zion has co-founders. Do you know Todd?

Oriana Papin-Zoghbi: I've heard of him, but I don't know him personally, yes.

Sal Daher: Okay. He's been on the podcast and he has co-founders that he co-founded before and he's working with them again. Mike Singer of Cartesian. You know, Mike?

Oriana Papin-Zoghbi: Yes, I do.

Sal Daher: Well, he and Murat have founded this is their third company together. This is a recurring theme. You tend to work with people that you trust, that complement you. Perhaps the best-supported result in the study of entrepreneurship and this I have from Ed Roberts, Emeritus professor of entrepreneurship at MIT, and also from Chuck Eesley, who is a professor of entrepreneurship at Stanford, is the more co-founders, better. Lone founders have a really hard time. If you have a second co-founder who complements a founder in skills and in personality, hugely increases the chances of success. Third co-founder as well. You guys are the right formula, the AOA winning formula.

Oriana Papin-Zoghbi: I would agree. [laughs]

Sal Daher: Tell me the story of the first startup you guys did together, how that came about. How did the band come together?

Oriana Papin-Zoghbi: Band came together individually. At this time, we were working for a company in Boston. I was hired as an intern in my senior year of Boston University. I speak a number of languages and at the time I was hired to really help expand into global territories because of the fact that I spoke Spanish, Arabic, and French. At the time, Anna had already been working there, she'd been there for a few months, and Alex was working out of London, his family-owned distribution business of medical supplies, and they distributed this product into the UK.

The three of us met there for the first time and our goal there was really to focus on expanding commercialization globally and to start thinking about how we were going to prepare the company for a sale to go onto acquisition. We worked on that, that company was acquired in 2012 if my memory serves me right. All three of us stayed on then for the two years post-acquisition with the integration of the company and then from there--

Sal Daher: Was this company a company that you founded or that you were working at you're hired?

Oriana Papin-Zoghbi: We were all hired in, exactly. We were all hired in that's right. From there, somebody we were working with was co-founding another company out of the Harvard Innovation Lab and this time he came to us to be part of that early founding team and said, "I'm building another company in the woman's health space I'd love to work with you guys again." We all got back together again. We were formed part of a much bigger team this time as well with a very specific sniper goal, which was develop the technology, get FDA approval, sell it back to the strategic.

Then that went through, that exited in 2018, and now the three of us got together again and said, "Okay, let's do this from start to finish ourselves now." Then that's when we went on the hunt and met Professor Saragovi and kicked off AOA. We never had the intention of calling the company AOA I want to put that out there.

[laughs]

There was the three of us, okay, and we used to call ourselves the dream team. We were speaking with tech transfer offices, strategics, advisors, just a lot of thought leaders in the space, and we were introducing ourselves as we're this incredible team we're looking for the right technology to partner with, we found these focus areas, and they say, "Okay, so what's the name of your company? What's the name of your company?"

We didn't have a company, we had nothing but the three of us. We said, "Okay, let's throw our initials together. We'll call ourselves AOA and when we find the product, we'll officially incorporate the company as something that makes more sense." That officially incorporated makes more sense we still never changed our name. It's been two years, we're still here. Now it's stuck and I can't change it.

[laughter]

Sal Daher: That's so funny. My working theory when you were telling that, was that the moms got together and said, "Oh no, you have to make it AOA." [laughs] The proud moms that talked you into it. They said, "Oh no, but we tested with all our friends and it works really well, AOA."

Oriana Papin-Zoghbi: The justification we told ourselves after the math is that it looks great, it's symmetrical, it works for all kinds of branding.

Sal Daher: Paleozoic

Oriana Papin-Zoghbi: Exactly. Then A always comes up first on say when you're a presenter, when you're on conferences, it just puts you at the top of the list. We're like that, that makes perfect sense. That's our justification after the math.

Sal Daher: That is so funny. Let me take a little break. Next, I want to get into your entrepreneurship journey. Before that, I want to say a few words about the sponsors of this podcast. This podcast is sponsored by Purdue University Entrepreneurship. I don't know how much you know about Purdue, but Purdue is really a remarkable place for entrepreneurship. Maybe after you exit with your McGill collaboration, you might check out Purdue because they have really exceptional School of Engineering.

It's a top-five School of Engineering. They have like 500 engineering professors. They have something called the Purdue Foundry, which sends out emissaries to the professors and sits down with them and helps them figure out ways to take their tech from the lab to clinic, to industry, and so forth. I know this firsthand because I'm on the board of Savran Technologies, which is a Purdue company. That's how the whole thing came about. Keep Purdue in your mind.

Oriana Papin-Zoghbi: I will.

Sal Daher: Another recommendation, another sponsor of my podcast is Peter Fasse, who is a patent attorney at Fish & Richardson. Fish & Richardson is the premier patent law firm. Peter, he's my brother-in-law but that's not why he sponsored the podcast. It's because he is really very tops at his field. As you well know, the intellectual property for, especially, a life science company is everything. Having defensible patents that are as broad as possible but yet can be proved, is a very subtle game. Anyway, so that's the plug for my excellent sponsors.

Anyway, Oriana, when did this entrepreneurial leap happen, in your mind? When did you decide, instead of just-- Because you have a skill that is extremely marketable, okay. You're a very, very capable person in sales, in highly technical sales in the biotechnology space. Someone like that can earn massive amounts of money without all the worries of starting a company and so forth. Why is it that instead of just rolling in dough, as a very, very successful, vice president of sales at some hugely successful company, why did you decide to start something of your own?

Oriana Papin-Zoghbi: The biggest reason, I would say there are two that go hand in hand together. The first is having been in the women's health space for the last decade, I experienced firsthand how challenging it is to drive change. How lack of an investment, how little prioritization on innovation happens in women's health. It was a partial idea that I'm an expert in this domain, I'm passionate about it. If I don't go out there and focus on it, how am I going to expect others to, or to really rally behind this cause? I'm somebody that, as you said, I could've made big bucks being a VP of sales, selling these products but there's so much that is missing before a product is even ready for sale.

That's truly I would say was one of the biggest drivers, is there is this need in women's health. I am very familiar with this space. I'm very passionate about it and I could have an impact. Then the second part goes back to Anna and Alex, which is I love working with these two. The three of us together have a phenomenal ability to work together but also a really good success record, and so, let's use that. It was this idea that I really want to create something with my friends, as cliched as that sounds, but I want to build something with people that I am so excited to work about and I want to build something that I'm so passionate about.

That's really what took me to the next step and said, "I don't want another sales job." When I made that leap, I was Director of North America for what is now a unicorn company in the 3D printing space. I was lined up to do great things with this company. Great company, I could have had a phenomenal career heading up all of North America. I could have made like you said, big bucks without having the stress of worrying about building my own company but that isn't what necessarily drives me. It's this idea, I want to work with phenomenal people and I want to build something that's going to have an impact, especially in an area that's currently underserved.

Sal Daher: Excellent. Very, very good reason. It's your passion, a mission that you've taken on. It's understandable. Some of the best salespeople are extremely passionate. They are people who are so passionate that they are capable of bringing other people along with them on their journey. Okay, which brings me to another aspect of sales. Tell me about the raise that you just completed. Do you feel comfortable talking about that and what you learned-

Oriana Papin-Zoghbi: Yes, absolutely.

Sal Daher: -from the raise? A lot of people who listen to this are entrepreneurs who are going to face a raise. You know Jeff Behrens, right?

Oriana Papin-Zoghbi: Yes.

Sal Daher: I saw on your LinkedIn profile. Okay, so Jeff Behrens, he was the CEO, a company called Siamab.

Oriana Papin-Zoghbi: Yes.

Sal Daher: It was cancer therapeutics now he had an exit but it raised something like $14 million from angel investors were never able to get venture money and he thought, "Is it me? Am I doing something wrong?" After that, he dedicated himself to study the funding of life science companies. Are you familiar with what I'm saying now?

Oriana Papin-Zoghbi: Yes, I am. I've had great conversations with him.

Sal Daher: You have?

Oriana Papin-Zoghbi: Yes.

Sal Daher: Okay, so you know the problem. The problem is that the venture capitalists, the big players such as flagship pioneering are kind of rolling their own startups, they're creating their own startup built in-house which they fund what Jeff used to call the $50 million babies.

Oriana Papin-Zoghbi: Yes, they fund, they staff. Yes.

Sal Daher: Now they're $400 million babies, things have grown and there is this massive amount of venture capital, chasing these moonshot projects, and yet, there's tons of stuff in the life sciences and as you all know, Oriana is going to be even more coming along the line and they have to be funded by angels, which you are. This is for me is extremely important, because I want to talk-- Angel investors who have been investing in software companies that come over to the life science side. You are tremendously passionate. Make your pitch for that. Why should you not invest in the nth platform, the this of that, and instead go find some academic that's taking some remarkable technology out of a lab like your researcher at McGill and back that person?

“...I can make the case for life sciences and that is where we are today is at the cusp of innovation, or medical innovation in the life sciences, this is truly just the beginning.”

Oriana Papin-Zoghbi: Yes, absolutely. I don't want to compare to software. I don't know enough to say this or that, but I can make the case for life sciences and that is where we are today is at the cusp of innovation, or medical innovation in the life sciences, this is truly just the beginning. There is so much that’s to come and there is much variety, in the type of work we're doing. Everything from what you said circulating tumor DNA, to the microbiome to point of care testing that there is such a need for investment to go across all these different spaces to give us a chance to live a longer life and live a healthier life.

“...our ability to beat cancer or Alzheimer's or other types of diseases. It's that impact investment that is going to make a difference 30 years to come from now...”

If there's anything to be made for the case of life sciences it's because this is truly something that will impact you, your family, and your generations to come. You could be a user of a software platform, or you could just think it's a good idea but at the end of the day, investing in the life sciences is investing in the livelihood of mankind and our ability to beat cancer or Alzheimer's or other types of diseases. It's that impact investment that is going to make a difference 30 years to come from now, 50 years from now and there is huge need.

I think that's where I agree with you it's like bring people over, there is not a lack of investors in software, quite the opposite. I think there's so many of them and entrepreneurs are getting their pick but there is still a lack of investors in the life sciences, especially in diagnostics being the underdog. COVID is sort of changing that in that people are finally realizing the need for diagnostics but at the end of the day, what we need is more people to help us bridge that gap from academia to industry. I believe the statistic is 90% of medical innovation remains in academia, can you imagine?

Sal Daher: I believe that entirely. I think I've seen something similar to that effect.

Most of it doesn't make it out. What I see happening that's changing that is that 10 years ago, there were very small handful of academics that were trying to take their technology from the lab to the clinic or to industry. Now there are a lot of supports, for example, iCore, programs such as the one that I mentioned at Purdue University. In the School of Engineering at Purdue University, they evaluate faculty, not just on publication citations, and so forth on how many patients they're filing and getting approved, if they're starting a startup, it's amazing.

There's a change that's happening so we have a lot of academic founders coming out and trying to start companies. I've invested in a bunch of them, things as diverse as instant diagnostic for the presence of bacteria using quorum-sensing molecules, it's a professor at Northeastern, QSM. It's one of my favorite startups because basically a million and a half has put them into a position of having a product on the shelf. They went the veterinary route, but in three or four years this is going to be human test that's on the roadmap, but we need more investors.

I think the life sciences are far more accessible than people give it credit for. Admittedly, it's a really hard space but at the same time, if you have patent protection.

Oriana Papin-Zoghbi: Yup!

Sal Daher: If you have strong patents, talking about my other sponsor, Peter Fasse but it's very true. If you have strong patent protection, what that does is it allows your company to build really significant value. A case, for example, when I think of Siamab, Jeff Behrens' company, that was $14 million raised, they had some non-dilutive funding and then they sold north of $200 million, very nice exit. Those angels that really well. Of course, poor Jeff [Behrens] had a heck of a time raising all that money. $14 million in angel money is a lot of work, you can attest to that.

Oriana Papin-Zoghbi: I can definitely.

Sal Daher: Let's get specific. What things did you learn that could be valuable to other founders?

Oriana Papin-Zoghbi: The biggest thing that I learned is don't eliminate the smaller check sizes because you're holding out for the big dogs down the line. That's actually a good lesson that Y Combinator really educated us on. That's because sometimes your smaller checks can lead you to an introduction to a bigger check, and to a bigger check, and to a bigger check. Also, that smaller check can also bring you value by providing you introductions to great talent or to strategics in other ways.

That's the plug for angels is that an angel with a smaller check is not necessarily less valuable than a VC with a large check. Especially because angels will usually be your first money in which just gives you ability to get the ball rolling than holding out for the big guys essentially just is more and more time that you're not building.

Sal Daher: I agree with that entirely. Our fellow Lebanese American, Waseem Daher, no relation to me, Daher. As they say in the Middle East, is that the Daher family in Lebanon is a big family because it means it's a common name. It's like Jones. It's a very common name but in the Middle East, they have a more poetic way of saying it, big family.

Waseem is co-founder of his third startup, very successful VC-funded, Pilot.com and he wrote a post, which is saying exactly that, don't mind having a lot of names in your capitalization table. Of course, you don't want to have a toxic angel, no matter how big the check is. Very few toxic angels, they should be known as devil investors instead of angel investors.

Oriana Papin-Zoghbi: I haven't come across any that has been like that. When I walked into this, I don't want an enormously large-cap table and how are we going to manage that and et cetera but at the end of the day, that was head trash that I had just built into my head without truly understanding what good investors meant. It's not about the number of investors and it's not just about how big the check size is, it's is that person bought into your mission? Do they believe in you, not your product, not your company, do they believe in you? Because your product could change, your company could pivot but hopefully, you're not going anywhere. Do they believe in your ability to get to that success marker, whatever that success marker maybe?

I think that's truly what we focused on is who is bought into Oriana and Alex and Anna as the team to develop solutions and bring them to market? Today it's ovarian cancer and I hope that that's our first product to market, but God knows what's going to come at us. It's our investors that believe that we have the ability to overcome challenges with the FDA, overcome challenges that come at us with clinical trials, overcome burdens of having to deal with COVID in the workforce, and are really behind us that say, "Okay, this is the right team to execute on that mission."

Sal Daher: This is very well said. I agree with it, Waseem Daher, no relation, agrees with it, but you have expressed the best of all with such excellent passion and a very clear explanation. Any other thoughts for a fundraising other than just don't disdain the small checks?

Oriana Papin-Zoghbi: On the flip side of that. I would say, really find investors that align with you and don't take money from anybody.

Sal Daher: From just anybody.

Oriana Papin-Zoghbi: From just anybody, exactly. Have conversations with the universe, build a strong company that then allows you to pick which investors from that universe you would want to talk to. I talked to Tech Investors like your typical Tech YC investors. I talked to angels that have invested in anything. I had talked to life sciences-specific investors, diagnostic-specific investors, women's health-specific investors, females founders-specific investors, from wide to narrow. I spoke with everybody that would take a meeting with me and those that didn't, I insisted until I got a meeting with them. Then in the meantime, truly, Anne and Alex were building, building, building, right. Getting our clinical data, forming the partnerships, getting everything ready so that I could go out and sell that to investors and then we have the ability to say, "These investors align well with our mission and are going to take that journey with us." Which is they are familiar with diagnostics. They understand their hurdles, and they're willing to come on this journey. They have a passion for women's health or for impacting this space. They have connections to so and so strategics that could help us down the line. Then we could essentially be more picky. Again, everything that I mentioned there, none of it is on check size.

Sal Daher: No.

Oriana Papin-Zoghbi: I wasn't in any way prioritizing who was going to take up a $3 million check. I was prioritizing who believes in me, who believes in women's health, who's going to understand the hurdles that I'm going to go through, who's not going to scare easy and who wants to join us for the journey just as much as for the outcome?

Sal Daher: Outstanding. Would you like to say something about your experience at Y Combinator?

“I fully attest to the value Y Combinator gave us...”

Oriana Papin-Zoghbi: Sure. I'll start with saying I was very hesitant. A number of people told me to think really, really hard before making this decision. As this is in the springtime, we were really thinking hard which incubator would we do? Which incubator accelerator would we do? Then what value are we going to get out of it? I'll just say this. Having done it now, I fully attest to the value Y Combinator gave us and the single-- Not the single, maybe. One of the most valuable elements of going through Y Combinator was working with Surbhi Sarna. Which Y Combinator just announced a few days ago, they have now made an official partner for bio and healthcare. For a bio and healthcare company, if you're looking to raise money, and build strategy in the early seed days, Surbhi is just a phenomenal person to work with.

For us specifically. She founded nVision and knows the ovarian cancer space so much. More than that, to take it to the next level, she understands what are investors looking for, and how to package and build that mindset. We saw incredible success coming out of it. We made connections with other founders that to this day we're still very close with, in the sense that, we can ping each other and ask, "Well, what did you do in this scenario? Who's your regulatory consultant?" "Who did this?" The founder journey can be quite lonely. I'm lucky enough to have great co-founders. Even with that, sometimes there are certain areas where we still like to have a broader community. We had a phenomenal experience. We're very excited that it was remote because we're an East Coast company, we would never have moved. I didn't believe in the hype enough to move to Silicon Valley to build a company out there. I'm very glad.

[laughter]

Oriana Papin-Zoghbi: I hope nobody hates me for saying that. We're East Coasters, and we're proud to be. We're glad that we were able to do it remotely. It was worthwhile for us in the end.

Sal Daher: That's really great. I remember seeing you pitch at Walnut Ventures, which is an angel group that I belong to. You took my breath. It was a really very excellent pitch. I was like, "Wow."

Oriana Papin-Zoghbi: Thank you.

Sal Daher: Then tried to get together after a while. Then you just-- Immediately after that you went to Y Combinator.

Oriana Papin-Zoghbi: That's right.

Sal Daher: I next saw you at TBD Angels-

Oriana Papin-Zoghbi: That's right.

Sal Daher: -where I'm also a member. I've invested in AOA via TBD. Would you care to talk a little bit about the different flavors of angels? We have Walnut, which is a very traditional angel group, and TBD, which is sort of a new angel group that sprang up during COVID.

“...TBD Angels I worked specifically with, or closest I should say, with Yael and with Vicky was, how quick and transparent all of our communication was.”

Oriana Papin-Zoghbi: Yes. We have experience with a vast variety of types of angel groups from a lot in the East Coast wall that we worked, where we pitch to, then we actually got investment from Beacon Angels, TBD Angels, Launchpad Venture Group. Then as well, individual angels coming in and investing in us from some of the angel groups or just from the individual network. One of the things I truly enjoyed a lot from working with TBD Angels I worked specifically with, or closest I should say, with Yael and with Vicky was, how quick and transparent all of our communication was.

In the sense that this is the day that we're having a meeting and I will commit to you that by Thursday, we'll have feedback. Thursday came around, and I got feedback. That was truly as an entrepreneur, trying to allocate and manage interest and not disappoint anybody and really ensure that we're moving things along swiftly. There was angel groups that were really communicative and actually met deadlines that they had communicated with us were such a pleasure to work with including TBD Angels. I also found that certain angel groups had more structured approaches to certain things and maybe were less comfortable to do things of in certain way. 

Sal Daher: I think it is very right.

Oriana Papin-Zoghbi: I can't say there is a group that I did not enjoy working with. The only note that I will make is that we were in early discussions with Keiretsu Forum, but I personally found the cost to pitch them really steep as an early-stage entrepreneur.

Sal Daher: Cost?

Oriana Papin-Zoghbi: Oh yes.

Sal Daher: What cost?

Oriana Papin-Zoghbi: You have to pay to pitch to their members.

Sal Daher: Oh, my gosh.

Oriana Papin-Zoghbi: Some groups in Boston will have a $50 or a $200 fee to pitch. Fine, I understand. They have a website to manage et cetera but this was $5,000 to pitch, $16,000 to pitch just certain chapters.

Sal Daher: I don't like that model at all.

Oriana Papin-Zoghbi: I was just shocked. I said, "I have no money in the bank. I haven't taken a salary for a year. I am bleeding my savings, how am I supposed to pay you right now?"

Sal Daher: This is New England. Walnut Ventures, the annual fee to members is $400. TBD there's no fee, it's like for members to blog and they don't charge entrepreneurs anything. It's like "We're here to write checks. We're not here to receive checks."

Oriana Papin-Zoghbi: Yes. I was like, "Okay, probably not my model."

Sal Daher: Doesn't make sense for me. This is terrific. Oriana, let's step back now. Oriana Papin-Zoghbi, part of your family comes from the Middle East. Tell me the story of your family and how you came to be here.

Oriana Papin-Zoghbi: My family is originally from Lebanon. My mother's parents individually migrated to Venezuela during the time of the wars but this was separately. My grandpa and grandma individually migrated to Venezuela.

Sal Daher: Which wars?

Oriana Papin-Zoghbi: This was during the civil war. Exactly, the civil war. The civil war, they moved to Venezuela individually. They met there, had a life in Venezuela, had my mother and all of her sisters separately. My father's also from Lebanon, grew up in Lebanon all of his life. My parents ended up meeting one year in Lebanon and after getting married, my father had already been working in Saudi Arabia so I lived in Saudi Arabia and I grew up in Saudi Arabia. I lived there for 15 years all of my childhood and from there, I went to boarding school in Switzerland, and then from there I came to Boston to do an undergrad in economics, Boston University.

Sal Daher: Outstanding.

Oriana Papin-Zoghbi: Then from there I took that first job that I mentioned. When we were acquired, we were acquired by a German company so moved to Germany, worked at their headquarters for a few years, met my husband who is not German but French, that's where the Papin comes from.

Sal Daher: Oh, okay.

Oriana Papin-Zoghbi: My husband is French. We met in Germany. We moved back a few years later to Boston and then we eventually got married. Now I have a hyphenated French Lebanese name and speak four languages. We recently had a daughter who we are trying to teach all the languages to.

Sal Daher: Congratulations. That is so wonderful. When was your daughter born?

Oriana Papin-Zoghbi: Three months ago.

[laughter]

Sal Daher: Well, Bettina Hein, the founder of Pixability. Have you met Bettina?

Oriana Papin-Zoghbi: I have not.

Sal Daher: She's founding a new company now called Juli. She also was expectant and raising money and doing all that. I think that's going to become much more the norm going forward.

Oriana Papin-Zoghbi: I certainly hope so. It's hard, do not get me wrong. There are incredible challenges but the thoughts that kept coming to my mind is that had it been my husband that were CEO, nobody would've either asked him or wondered or questioned what his parental responsibilities were or his family plans. This is what people saw as a face on a screen the entire time. COVID granted me that opportunity. I wasn't flying across the world or across the country raising and pitching, I would've, but I didn't have to, and gave me the opportunity to birth a child in between my two rounds.

Sal Daher: Well, I'm a father and a grandfather, my older daughter is a physician and she was expecting during the first year of residency, third recency. Expectant women have just amazing-- It's tough but at the same time there's just so much energy, they're just focused, and no time for nonsense.

Oriana Papin-Zoghbi: Somebody told me that mothers are more efficient and I was like, "How is that possible?" Now, I understand it's because you don't have time for inefficiency, it's like, "What is the most critical and crucial, what email just don't need to get addressed right now, and what is actually crucial and critical?" I got to get that done before the next feeding or diaper change.

Sal Daher: Your survival instinct is at stake.

Oriana Papin-Zoghbi: Oh, yes.

Sal Daher: You're thinking about the baby, you're thinking about you and you become extremely ruthless in a very positive way. My daughter, supposedly she was done let's say eleven o'clock at night but she wouldn't be done with all the reports and everything else until well, 1:00 AM or 2:00 AM in the morning. We would go pick her up with food for her to eat on the way home and her husband had the baby at home, she would feed the baby go to sleep. Then 6:00 AM in the morning she'd be heading in and he would take her, we'd have the baby. Oh, it was just amazing, the system is.

Oriana Papin-Zoghbi: My hat goes off to doctors, nurses, women who are on shift schedules too they really have to also manage having a baby and trying to grow a family. I've seen surgeons who are ninth-month pregnant operating in 10-hour surgeries. Having been nine months pregnant, I can guarantee you, there was no way I could stand for 10 hours at a time, just simply no way.

Sal Daher: We have a babysitter who wants to be a neurosurgeon and she's probably going to be, she's an incredibly, incredibly capable young woman. I'm just thinking, "Neurosurgery that's where you have the 10-hour surgeries."

Oriana Papin-Zoghbi: It's hard. Props to her, I hope she does it.

Sal Daher: I hope she does it. Maybe she could do other surgeries that don't take as long, it doesn't have to be neurosurgery. At this point, Oriana we've covered your entrepreneurial journal, we've covered the founding story of AOA, the naming story of AOA, Y Combinator and all these tremendous things, we talk about fundraising. Is there anything else that you want to leave our audience, our founders, people who work at start-ups, people thinking of founding companies, and most importantly the Angels, a message that you would like to leave for them?

Oriana Papin-Zoghbi: On both sides, on founders and on Angels, I think the biggest message that I would give that we experience is, don't take no as an answer. From the very beginning of what AOA was which was even finding the technology and meeting with tech transfer offices, we got a lot of nos. I remember getting on a flight because we were so close to signing a deal, we were in Boston we got an overnight flight to Portland, Oregon with the intent to close the deal.

When we got there, the deal fell through and we flew back that same day. This was a 24-hour red-eye back sitting at that airport being like, "Why did we just fly here, this is not going to work?" Then getting a good night's rest and looking back at Anna now, I can say, "Okay, let's try this again." It's a resilience. So many people are going to say no and that's not a testament to who you are or your idea or your work.

Just keep going on get up the next day and the same even with Angels, right? When you hear founders say no, hope that they come back to you because the ones that came back to you are probably the ones that are also going to go back to the FDA or going to go back to solving a problem. That's a testament to who they are and don't necessarily think that they're annoying, they're just persistent in the right way.

Sal Daher: Well, you have encapsulated the essential quality that is necessary to be successful at sales, which is organization and the ability to take no and come back and try again. It's a heroic thing, people say, "Always sales, oh, used car salesman." Actually, the art of persuasion was valued very highly. The Greeks had as the patron of persuasion, Athena the goddess of wisdom the, grey-eyed goddess of wisdom was the goddess of persuasion.

Salesmanship is a very, very important thing. America is very good at sales. What that means is, it's very good at finding the people who need something and giving it to them; creating human satisfaction in a material sense. It's not everything, there're higher things in life but in terms of material fulfillment, that is a really important discipline which people undervalue I think. You are an outstanding examplar-

Oriana Papin-Zoghbi: Thank you

Sal Daher: -of that calling.

“...for anybody that is interested in the art of persuasion, I very much recommend reading about Robert Cialdini and his books...”

Oriana Papin-Zoghbi: Thank you. I appreciate that. I would absolutely agree, for anybody that is interested in the art of persuasion, I very much recommend reading about Robert Cialdini and his books and exactly those things. He talks about this in all elements, not just in sales but really, as you said, mastering that skill but yes, this is this has been such a delightful conversation. I'm so glad to be here.

[music]

Sal Daher: I wrote that, Robert Cialdini?

Oriana Papin-Zoghbi: Robert Cialdini yes.

Sal Daher: Yes. Excellent. Thank you very much. Oriana Papin-Zoghbi, I'm very grateful to you for being on the podcast, and for giving such an excellent testament to the value of sales, the value of persistence, and just being a Hardhead, that business person, and teamwork and leadership really, thanks a lot for being that excellent testament and for making the time to be on.

Oriana Papin-Zoghbi: Thank you for having me. It was such a wonderful conversation. I really enjoyed it. I look forward to hopefully coming back and sharing more stories with you in a year or so and seeing where we are.

Sal Daher: I look forward to that. Oriana, you have a standing invitation to come back anytime that suits you. Okay.

Oriana Papin-Zoghbi: Thank you so much. I appreciate that.

Sal Daher: I'm sure you have excellent things to tell us. This is wonderful. This is Angel invest Boston. I'm Sal Daher.

[music]

I'm glad you were able to join us. Our engineer is Raul Rosa. Our theme was composed by John McKusick. Our graphic design is by Katharine Woodman-Maynard. Our host is coached by Grace Daher.