P | P | P feat. RareCan Limited.

We caught up with Piers Kotting, CEO and Co-Founder at RareCan Ltd, a novel company accelerating research into rare cancers.

The purpose of article series ‘Product | People | Potential’ is to feature and showcase the very best UK start-ups with great potential, truly inspiring businesses that are shaking up their sector. We capture and share the stories behind the name. We collate authentic peer to peer real-talk, while celebrating the growth and success thus far and gather a glimpse of what’s ahead.

Jazz @ADLIB: Can you please introduce yourself and RareCan, explain what RareCan does, what stage you are at currently and what makes your business and offering unique?

Piers Kotting: I’m Piers Kotting, CEO and Co-Founder at RareCan, a new company founded in 2020 to accelerate research into rare cancers.

Researchers around the world are looking at better ways to diagnose and treat rare cancers. Today there are 740 global life sciences companies investing in 950 products that include a rare cancer target^[1]. This translates into an accelerating number of clinical trials taking place, all requiring access to consenting patients, secure data, and bio-samples. If not readily available to researchers, desperately needed progress in this area becomes at-risk.

At RareCan, we are pairing a new platform of a large and growing patient community with a BioResource, giving researchers access to tissue and blood samples, as well as genetic data, to accelerate research into the prevention, diagnosis, or treatment of rare cancers. We’re reducing the time taken to provide samples for research purposes from months to weeks.

Our patient community includes individuals across the UK living with a rare cancer diagnosis, many of whom currently have a severe lack of treatment options, who want to get involved with and support research in this area.

Our platform enables researchers to find the exact patients or tissues needed for their rare cancer targets. This means RareCan can build precise cohorts of trial participants, and enable the delivery of histology-independent trials, targeting genetic mutations common across a range of different rare cancers, including solid tumour types associated with cancers such as breast, colorectal and pancreatic.

For us, the focus is on levelling the playing field between the rarer cancers and the more common cancers – rarer cancers typically have poorer survival rates than the more common cancers, and we believe is primarily because less research is done into rare cancers. Our mission is going to take time but will have a massive impact in the future.

We’re working in an early market with some other companies offering a similar service, but RareCan is the first and only company in the market to bring together ‘consent to contact’ patient recruitment, an abundance of data to ensure accurate screening, and access to bio- samples and genetics. This is the future of clinical research.

We raised our seed funding in December 2020 and have just started our second round…so watch this space.

Jazz @ADLIB: On that point, can you share your definition of a Rare Cancer please?

Piers Kotting: This is an interesting question, and there is no easy answer here, but simply put, the accepted definition is less than 6 in 100,000 people, which encompasses around 180 rare cancer types. Between one quarter and a fifth of all cancers are considered to be rare, which equates to 70,000 people per year – so rare cancers aren’t rare at all! For us, if there is an area of cancer which has an unmet need, even if that is a rare variant of a common cancer, then we will support that.

Jazz @ADLIB: Can you share the story behind the origin of RareCan?

Piers Kotting: We are founded by a group of passionate individuals which combines parents who lost children to rare cancers and want to make a change, along with people in the public sector research space who spent years trying to accelerate research in the lab and clinic. We have an incredibly supportive, experienced, and fully constituted Board, with an independent Chair, who is very knowledgeable in the world of ethics and the use of human tissue.

We all recognise that, building on what has emerged from the COVID pandemic, public sector investment in digital and data-enabled support for clinical research is firmly focussed on building large scale generic platforms that make use of high-level routine clinical data. As the pharmaceutical industry increasingly focuses on rare forms of cancer, there is a need for the more highly targeted approach that RareCan provides, with access to detailed clinical, molecular, and genetic data to identify the right patients at the right time.

Before RareCan, I set up a similar company initiative on dementia, called Join Dementia Research, a service that allows people to register their interest in participating in dementia research and be matched to suitable studies.

Jazz @ADLIB: Starting with People, can you share some challenges you have faced, are facing, or are anticipating around scaling and growing your team? Do you have any top tips you could share with those businesses faced with the same issues?

Piers Kotting: The team at RareCan have been incredibly important in our journey so far and of course will continue to be so. We have a really good working relationship which allows challenge and debate in order to agree and move forward. Having enough people, and the capacity to push forward, is always a challenge in start-ups. From past experience, a top tip of mine is to invest in understanding the skillset within the company, and ensure you fully utilise everyone’s potential. Also, to leverage the network you have and be as open to help, and asking for help, as possible.

Jazz @ADLIB: Moving to Product, which in your case is probably considered a service, what has been your approach to understanding the Rare Cancer market and implementing your product market fit?

Piers Kotting: To start to approach this question I think it is important to emphasise that the area in which we are working extremely complex. How one approaches a product market fit is dependent on the understanding of the market and what that market looks like, however, to a degree, what we are doing is system innovation. We are connecting different parts of a complex pathway to improve efficiency, understanding where value is and what is required by the system overall. Our approach has been to talk to a lot of people within the system, and remain goal driven, as well as product driven.

Jazz @ADLIB: And then Potential, can you share some challenges or barriers you had to overcome to create a Service offering with potential?

Piers Kotting: One challenge has been finding the most suitable technical approach. I initially approached with a mindset that we required a bespoke technology platform; however, this has not been the case and for us, technology is purely a commodity, an enabler – we have used out-the-box technology and it has definitely been the correct approach in this case. Configure not build! As a result, we now have a massively powerful platform that we can evolve to suit our needs without the need for huge investment in technology

Another challenge was matching the ethical requirements of good governance of human tissue, with the commercial requirements of a company. We have overcome this by being completely transparent and harnessing the wishes of our members – people with rare cancer. We received NHS ethics approval for our bioresource recently and have a partnership in place with Teeside University to start sequencing our samples. In order to ensure the highest standards of governance, we have established an access committee that is independent of the company.

Jazz @ADLIB: Investment can often be a challenge for start-ups & scale-ups. Do you have any piece of wisdom you could share around best approach?

Piers Kotting: I came from the public sector, where I was continually bogged down focusing on the areas I wasn’t quite sure about, or felt I didn’t know enough about. When my focus shifted to higher level and I simplified the idea I had more success. So, the advice would be to not let the areas you are not sure about get in the way of the big picture, focus on the issue you are addressing and who you are to inspire belief from investors. There will always be uncertainty and risk involved in start-ups, which is precisely why we look to the types of investors we do.

Linked to that is the advice to not be scared! Be confident in what you are doing. Explain it simply to make it accessible and understandable.

Additionally, something that we found really helpful was regional support – having a home – we raised a proportion of our money through North Invest, look for local people to support you.

[1] https://www.iqvia.com/insights/the-iqvia-institute/reports/global-oncology-trends-2021