In this three-part blog series, Neal F. Kassell, MD, the Founder and Chairman of the Focused Ultrasound Foundation, talks with Chase Koch, the President of Koch Disruptive Technologies (KDT), about the field of focused ultrasound and how their organizations are working together to revolutionize therapy with this highly disruptive technology.

This blog, the second in the series, is edited and condensed from their discussion and explores the state of the field of focused ultrasound as it transitions from the research to commercialization phase, the role of the Foundation, and KDT's relationship with the Foundation as they pursue their shared goal of improving the lives of millions around the world in the shortest time possible with this revolutionary, noninvasive technology.  It begins with Dr. Kassell talking about the field of focused ultrasound and the role of the Foundation.


Kassell 2018 2x3Focused ultrasound is a big deal. It's is an early-stage, noninvasive therapeutic technology that is a highly disruptive, game-changing alternative or complement to traditional surgery or radiation, a new way of delivering drugs in extremely high concentrations precisely to the point in the body where they're needed, and a way to stimulate the body's immune response to cancer and thereby augment or enhance the effectiveness of cancer immunotherapy drugs.

The technology will transform the treatment of a variety of serious medical disorders, including Alzheimer's and Parkinson's disease, epilepsy and stroke, OCD and depression, arthritis, benign and malignant tumors of the brain, thyroid, breast, lung, liver, pancreas and prostate, and many other conditions. Thereby, it holds the promise of improving the lives of millions of people around the world.

In 2017, approximately 100,000 patients were treated in 60 treatment sites around the world. The Foundation's goal is that by 2035, more than one million patients will be treated in as many as 10,000 treatment sites around the world. Today, there are more than 130 indications or disorders in various stages of research and development and commercialization. Approximately 30 of these have regulatory approval around the world, with five from the US FDA including prostate, essential tremor, Parkinson's tremor, pain from bone metastasis, and uterine fibroids.

Being totally noninvasive, focused ultrasound can be performed on an outpatient basis with no incisions, less pain, and decreased complications – including hemorrhage and infection and collateral tissue damage – which translates into more rapid recovery. It really is one of the rare technologies that fulfills the Holy Grail of both improving outcome and decreasing the cost of care.

It will be as revolutionary to therapy as magnetic resonance imaging was to diagnosis, and will spawn a multibillion-dollar industry, but it's in its early stages of evolution; it's where MR was 30 or 35 years ago.

State of the Field
Fields like focused ultrasound evolve exponentially. The growth of focused ultrasound has been much more rapid than anyone anticipated. We're just now at the inflection point of this curve, and the dialogue has shifted from "if" to "when" focused ultrasound will have a real role in the therapeutic armamentarium. And our job is to make "when" now.

Every month that transpires where focused ultrasound is not available translates into unnecessary death and disability and suffering for countless people. Our mantra is: "Saving time, saving lives."

But more importantly, focused ultrasound is just at the point where it's transitioning from primarily a research environment to a commercial and patient treatment environment. The predicate for our vision of one million patients being treated around the world annually is having successful commercial organizations to manufacture and distribute the technology. The research phase has been driven primarily by philanthropic dollars from foundations and individuals and government, but the commercial phase will depend primarily on investment from the private sector – more on that from Chase Koch below.

Role of the Foundation
The evolution of any new highly disruptive therapeutic technology – from idea and concept and laboratory research to widespread utilization as a mainstream standard of care – is a glacial process that often takes decades. And every month – I'm repeating myself but it's important – every month that this technology is not available is translating into unnecessary death and disability and suffering for countless people, including our friends, our family, and ourselves.

In October of 2006, we created the Focused Ultrasound Foundation as a unique, highly entrepreneurial medical research, education, and advocacy organization. Although we're not venture backed, we absolutely operate as a venture backed, high performance, high impact, high technology service organization in the private sector. All of our systems and our processes and our culture are what you'd see in a similar organization in the private sector.

Our strategy is to examine on a regular basis (quarterly), the critical path from laboratory research to widespread utilization as a standard of care. We identify the choke points or barriers, and then we apply resources where we can be effective in overcoming those barriers and make an impact.

We have a variety of activities that we engage in: We've become the compass or the guiding light for the entire field; we influence the direction of the field by identifying critical unmet clinical needs and setting research priorities; and we work hard to change the culture of the entire ecosystem – all of the stakeholders in the ecosystem – to make them more patient-centric with a high sense of urgency and collaboration by breaking down silos of secrecy.

One of our major activities is to organize, conduct, and fund research to develop the evidence of feasibility, safety, and cost. We educate clinicians and scientists through our fellowship and internship programs, and we orchestrate the flow of information by aggregating and sharing knowledge through our website, our newsletter, our webinars, and social media channels. And we organize and sponsor a number of meetings and symposia and workshops. There is much more information about all of this on the Foundation's website, fusfoundation.org.

[The dialog resumes at this point.]


KDT Kassell 600Dr. Kassell: So Chase, back to you. From your perspective, what most impresses you about the Focused Ultrasound Foundation and the contributions that it makes?

Mr. Koch: Sure, Neal, I can attest to what you all are doing and validate your strategy. I see it from my seat and I know the Insightec team certainly sees it in their partnership with you – to help drive faster adoption, more awareness of the technology, and research that wouldn't be in the marketplace otherwise, had it not been for what the Foundation is doing.

But to back it up a little bit at a higher level, the way we think about partnerships at Koch, we have a little bit of a mental model on this. Any successful partnership has three requirements: 1) we have to have shared values, 2) we have to have a shared vision of the future and where we could go, and 3) we need to bring complementary capabilities.

If I put Focused Ultrasound Foundation and Koch through that framework and that model, I think from a shared value standpoint, clearly we have them. We both believe in breaking barriers to transform people's lives. We both believe in driving what we call a republic of science – making sure that there's a global network to get at the best knowledge. That's critical for breakthroughs. We can't do all this ourselves; we have to leverage what's in the marketplace.

And we certainly both believe in creative destruction. I think both organizations are very entrepreneurial. Neal, I know your travel schedule and how hard you hit the pavement, and I see that in the rest of your team as well. So from a value standpoint, I think we get a big check there on our partnership.

Then from a shared vision standpoint, we're both trying to transform millions of lives and make a meaningful impact across this industry. And on the complementary capabilities, from the KDT standpoint, we're bringing capital to the game with Insightec as our key bet to advance the space. Hopefully, we're bringing some validation and some more credibility to the field as well with our interest there.

And then lastly, also regarding capabilities, from a regulatory standpoint and understanding how to navigate the space, which is highly complex, we have a lot of experience in navigating the regulatory waters here. And then from the capabilities that you went through, I think it's pretty obvious here: You guys have capabilities to create awareness, research capabilities, education, networking, and collaboration to connect the dots across the industry. You go through that model and I think it's a pretty darn good partnership. And so that's why we're excited about what you all have done and what we can do together going forward.

Dr. Kassell: Agreed. How has the Foundation helped Koch Disruptive Technologies?

Mr. Koch: The Foundation has certainly helped us in a lot of ways. I would say the first thing is really supporting clinical trials, for the whole industry which helps create awareness and improve research that otherwise would not be done. And I know there are several partnerships there with Insightec, which obviously helps KDT. You guys have identified subject matter experts and philanthropists to fund essential research to help grow the sector.

You've also helped us think through core questions in our diligence process of looking at the company when we didn't have a lot of background in the beginning. And you helped us expand our network in the field so that we can continue to understand and learn the landscape and figure out what growth opportunities are out there for Koch Industries and for KDT.

And I think broadly – I mentioned this before – but just creating awareness for the space. That helps the whole industry, and certainly helps Insightec and helps KDT. You guys do an excellent job promoting the sector and promoting the industry and bringing awareness to it in this space, as you mentioned before, that's relatively early.

Also, you mentioned, Neal, that it took roughly 30 years to get MRIs to be really that standard in the marketplace; I think we can do it much faster, especially with social media and new communication tools to get this out there, and the amazing network that you guys have. We're going to be able to really blow this out in terms of awareness and do it much faster than what we could do even 10 years ago.

So I'm excited to partner with you, with Insightec, with the rest of the field to do that. The other thing we need to do is continually apply creative destruction to our relationship as well. What I mean by that is, constantly change our methods and practices in creating awareness, in building our network, in everything that we do together to continue challenging and innovating the way that we've done things to tilt this curve even steeper.

Dr. Kassell: From the Foundation's perspective, we can't imagine having a more suitable partner than Koch Disruptive Technologies in that our values are essentially totally aligned, our visions are aligned, but most importantly, the chemistry on a personal basis works extremely well. So we're very grateful for your support, it's a pleasure and a privilege to work together on this noble cause, which will revolutionize therapy and improve the lives of millions of people around the world. And opportunities to be involved in activities like this only come around about once in a lifetime – the opportunity to employ capital and other resources, whether you're in the public or private sector, only comes around once in a lifetime. And it's a privilege for all of us to be involved in this.

Mr. Koch: Well Neal, thank you and the Focused Ultrasound Foundation for your partnership. We are certainly extremely excited to work with you and Insightec to make a meaningful impact to transform millions of lives.


The third and final article in this blog series takes a closer look at KDT's investments in the field, spawning the first focused ultrasound "unicorn" (a privately held company with a valuation of more than one billion dollars) via Insightec; why Mr. Koch says the Israeli manufacturer perfectly fits the vision of KDT; and future investment plans.  

Additional Resources
Listen to the fFull 40-minute Conversation on YouTube
Read the Transcript
Overview of the Focused Ultrasound Foundation
Learn More about KDT

Neal F. Kassell, MD, is the founder and chairman of the Focused Ultrasound Foundation.
Chase Koch is the President of Koch Disruptive Technologies.

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