Australian medical startup Ferronova has developed a nanoparticle based surgical oncology tracer system that aims to improve the treatment guidance, and staging of complex cancers. It is currently focused on testing and applying its nanoparticle technology to upper gastrointestinal cancers, which are associated with poor prognosis and low survival rates due to high incidence of locoregional recurrence and wide regional spread of metastases.

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Ferronova is based on collaborative research work by academics in a range of fields at the University of South Australia, Victoria University of New Zealand, University of Sydney, and the Royal Adelaide Hospital.

Chief Executive Officer Steve Bartlett has a background in medical device startups, and joined Ferronova in 2017 to steer it through its clinical trials and towards commercialisation.

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1. In a nutshell what is Ferronova about?

Ferronova hopes to improve patient outcomes in complex cancers by providing information to surgeons and radiation oncologists about which lymph nodes cancer is likely to have spread to. It is focused initially on oesophageal and gastric cancers. Patients suffering these types of cancers experience particularly severe side effects from treatments, significant post-surgery complications, and poor survival with only pancreatic and brain cancer having lower survival rates.

With this aim, Ferronova is seeking to apply nanotechnology to oncology treatment guidance. A nanoparticle is in the region of one thousandth the size of a human hair. The scientists working with Ferronova are specifically using iron oxide particles for precision imaging, surgery and therapy.

Iron oxide ‘tracers’ are injected in and around solid tumours and show clearly on an MRI scan. This allows treating physicians to track the path of metastases in the body through lymph fluid and into lymph nodes. This may allow more accurate surgery, for example removal of only those lymph nodes that are likely to be impacted by the cancer.

It is currently undertaking clinical trials, working towards its first regulatory approval.

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2. As a non-clinician what do you bring to the team?

I have a track record in commercialisation of medical technology. So I bring a broader perspective than just the desire to help patients.

In particular, I challenge assumptions, and have a ‘business mindset’ when thinking about the applications. I ask the questions about whether we are solving a problem that needs solving, or is a nice to have, and what that does to the market size and trajectory. The business mindset means assessing which market has the fastest regulatory pathway and best prospects for reimbursement.

It has obviously been important for me to learn about the research at a very deep level, and take time to get to know the people involved. That is the only way I can genuinely challenge, and make the right calls for the business and, ultimately, the people we are trying to help.

I have also been involved in overcoming aspects of technical challenges. For instance, in one case, looking outside Ferronova and finding that a team at the University of Sydney had novel intellectual property that could help us. We worked with them to licence that and in due course converted the license into a shareholding.

I also feel that as a non-clinician I can be a patient advocate, seeing patients as more than just a tumour, and ensuring the intrinsic motivation is about helping people. That is not just survival rates it is also reducing complications and side effects.

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3. Have the company’s priorities changed since it first started?

Yes they have, and I would say that is in some part my influence.

The primary focus of the application pivoted away from head and neck cancers towards oesophageal and gastric cancers as our first approval. Head and neck cancers are largely caused by smoking or Human Papillomavirus (HPV). Reductions in smoking, and the HPV vaccine, are therefore reducing the incidence of those cancers in developed countries. That is great for people, but it does mean a potentially smaller market for our product.

In a different way, lymphatic mapping is standard in breast cancer with several approved tracers and, while our technology is different, the potential impact on patient outcomes and reimbursement opportunities would be reduced.

It is not that we don’t hope to use our technology to help patients suffering with other types of cancer. I know though that it is important to understand market dynamics and the commercial imperative, particularly for this first approval, and therefore we need to select the market that has the greatest chance of impact and commercial success.

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4. What entrepreneurial tricks have you discovered in your career?

If I sum up what I have brought to Ferronova it would be the lesson of the leader getting down in the weeds, but you have to be alert to the strategic issues. It requires a combination of laser like focus to execute your plans, but always keeping a higher level view to look for new technologies or trends that either help or hinder your plan. Medicine is challenging as it takes a long time to get a product on market.

Resilience would also be absolute key. On all levels. You never know what the business is going to be hit with and it is your job to lead the company through and ensure it ‘adapts and overcomes’. For instance, we were just about to start our clinical trials when COVID hit. That is obviously something we couldn’t have predicted, but we had to navigate it or die!

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5. How do you define success?

As the CEO I have to define success, ultimately, as the shareholders’ return on investment. I have to understand what market and medical choices will lead to that financial outcome.

But, I am in this business because I want to be making a financial success out of something that helps people, and if we help people and patients the shareholders return on investment will happen.

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