Vikram Bajaj, PhD: “Innovation Doesn’t Come from Boston and San Francisco Alone”

Foresite Labs CEO and co-founder shares the firm’s approach to incubating data-driven drug developers, platform companies, and healthcare startups

Vikram (Vik) Bajaj, PhD, a Managing Partner with Foresite Capital leads its entrepreneurial innovation hub in launching companies focused on precision therapies, platform technology, and healthcare services and delivery as Co-Founder and CEO of Foresite Labs. [Foresite Labs]
When he joined Foresite Capital in 2017 after careers in industry and academia, Vikram (Vik) Bajaj, PhD, perceived a turning point in applying machine learning to increasingly complex datasets in the life sciences. He thought that integrating AI could impact everything from drug discovery to clinical trials to population health.

A year later, Bajaj received the opportunity to drive that inflection point when Foresite named him to head its entrepreneurial innovation hub Foresite Labs, which focuses on launching companies that apply data science tools to solve unmet medical needs.

Foresite Labs has since incubated five companies, two of which are in stealth mode: A precision platform therapeutics company leveraging novel genomic biology across multiple disease areas; and a developer of cardiometabolic therapeutics based on data science and human genomics. The other three companies are:

  • Esker Therapeutics, a developer of precision therapies for autoimmune diseases.
  • Interline Therapeutics, a protein therapeutics developer focused on systematically mapping and modulating protein communities. In May, it completed a $92 million Series A financing.
  • Sestina Bio, a synthetic biology company that develops food, therapeutics and apparel by applying ultra-high throughput single cell technologies.

Bajaj came to Foresite from cancer blood test developer Grail, where he served as chief scientific officer. Before Grail, Bajaj co-founded Verily (formerly Google Life Sciences), where he was chief scientific officer and chaired its scientific advisory board. A former academic PI, Bajaj holds academic appointments at the Stanford School of Medicine, Lawrence Berkeley National Laboratory and the University of California, Berkeley.

Bajaj—CEO and co-founder of Foresite Labs recently discussed Foresite Labs and its approach to incubating data-driven drug developers, platform companies, and healthcare startups with GEN Edge (This interview has been lightly edited for length and clarity).

GEN Edge: In what areas does Foresite Labs like to incubate and spin out startups?

Bajaj: One area is precision medicine companies. The idea is that we can replicate what has been so productive in oncology, where we understand the genetic drivers of disease. The patients who are responsive to our therapies targeted against those genetic drivers, their tumors harbor those genetic rearrangements, so there is a natural precision stratification strategy.

Now there are enough data for common diseases, autoimmune disease, cardiometabolic disease, CNS, other cases where similar concepts can be applied to accelerate product development, and ultimately produce better products for patients outside of cancer. Obviously, it takes a lot more data to do that than in oncology, which is why oncology is a decade ahead. But the pace of data generation and forming these other topics is growing exponentially.

We have been able to harness this to create a few companies that are tackling big, unsolved problems like cardiometabolic disorders, or autoimmune disease, which is on par with oncology in terms of healthcare expenses, but has resisted a molecular and genetic dissection.

GEN Edge: Which Foresite Labs companies focus on precision medicine?

Bajaj: Esker Therapeutics is in a precision medicine category; there are two other companies in this category that are unannounced yet. Esker has started with a deep genetic analysis of nodes that lie at the heart of multiple autoimmune diseases. Using Foresite Labs’ platform, it has produced an approach to target specific genes, specific targets from that analysis, in addition to understanding the patient response and stratifying patients in terms of drivers of autoimmune disease.

We believe that ultimately that precision approach will not only be better for patients who right now face a great deal of uncertainty in choices related to autoimmune disease therapies, but will let us get products on the market faster. Sometimes, testing drugs against these master regulator nodes in trials—that go across multiple indications with molecular measurements and correlates—tell us early hints of success.

GEN Edge: What are the other two areas of focus?

Bajaj: The second area includes Sestina Bio and Interline—two platform companies that are combining one or two new innovative areas of technology that, we think, unlock an area of biology that was very difficult to address before.

Sestina is harnessing all the toolkits that the world has developed for single cell biology to operate at the atomistic unit of biology, the single cell, to do experiments whose dimensionality is far, far, far greater than what was possible through the existing approaches in the field. That really allows the use of machine learning approaches and novel ways to harness biology and re-engineer it, or at least control it much more rapidly to produce new products.

Interline is another platform company with similar themes.The company combines everything that we know through human genetics and proteomics about protein-protein associations that function and malfunction in disease. Together with new tools from computational chemistry and machine learning, they can model protein-protein complexes and the effects of small molecules interacting with them at an unprecedented level of molecular fidelity and time resolution.That combination creates a toolkit for the first time, which we think will unlock the possibility of modulating with finesse these protein-protein interactions.

The final area is healthcare services and healthcare delivery. We have not announced anything publicly there. But it’s an area where the themes that we’re talking about—knowing the patients, understanding the patients’ experience of the disease, and what’s important to the patient—can be generalized into new patterns of delivering healthcare that is more responsive to what the patient needs, and what will improve the condition.

GEN Edge: You mentioned Foresite’s platform. What is that platform? How does it work?

Bajaj: The platform is really several components. The most important is the people that we’ve assembled on the platform, if I can count that among the elements of the platform. They are taken from a wide variety of places, but what they have in common is that they’ve used these tools before in a real biomedical or pharmaceutical development environment. That’s a rare group of individuals who have that depth of practical experience in creating data and using data.

The other elements of the platform are tools to harness publicly available data and some proprietary data and harmonize it, making it available for analysis.  Also, the tools to create these new datasets, which are not simple to deploy in a clinical scale with high quality. That data generation platform combines both of those.

And then, finally, there is a platform for the analysis of such data which is focused on the kinds of company formation and operation questions that we’re talking about. This is something that is purpose built to serve the companies that we create. To these precision medicine companies, we supply tools for genetic discovery and stratification of populations. To some of the more clinically oriented companies, we supply tools to analyze very large scale clinical datasets and turn that into useful information.

Most importantly, these things are done with unimpeachable scientific rigor. That’s very important to us, and that’s largely why we’ve tried to bring together these tools in a common platform.

GEN Edge: How does Foresite avoid a one-size-fits-all approach that platforms run the risk of, sometimes?

Bajaj: We avoid that in two main ways. One is that we’ve been very judicious about choosing which elements we would build into a platform and which the companies build out themselves. We are not holding on to these companies for years at a time. We’re trying to get them armed with the right toolkit and the right set of tools pointed in the right direction, and then in the hands of talented independent management relatively soon compared to what other incubators do. At least for most of our companies, that’s been the pattern.

As a result, we’re very judicious about what we invest in the platform. It’s focused on the kinds of companies that we want to start, say, in the next year or two. And that avoids a one-size-fits-all approach.

Another is that we continue to serve the needs of these companies after they launch, and partner with them. Many of our Foresite Labs employees are taking interim roles in these companies, for example, and so they’re quite focused on supporting those companies’ needs rather than abstract needs of the platform alone. So, that’s how we achieve a balance between what platform investments we want to make and how we serve the acute needs of the companies that we’ve created in the short term. We’d like to think that we are doing both, and we’re improving at doing both.

GEN Edge: How does Foresite Capital now interact with Foresite Labs? You’re also a managing partner with Foresite Capital. Does that mean you decide if Foresite Labs startups can access capital?

Bajaj: No. We have an investment committee at Foresite Capital that makes those decisions. Conflicts are managed by those who are involved in Foresite Labs recusing themselves from those decisions.

GEN Edge: If you form a company at Foresite, how much of that Series A financing comes from Foresite Capital, and how much do you draw other investors in?

Bajaj: Our pattern, without going into specific numbers, has been to draw other quality investors in as soon as possible after we launch. That said, in each of our launches, Foresite Capital has also played a role in funding them, and the team has tremendous confidence in those companies. We see the virtue of really having multiple viewpoints at the table for most of these companies.

The [investor] syndicates of the companies that have been publicly announced are quite diverse and not dominated by any one party. Our focus is on getting a quality set of experienced investors around the table for each one.

GEN Edge: Is that to say Foresite Capital was not a majority in any of those three announced companies, so far?

Bajaj: In some, it is. In others, it isn’t. It really depends on the nature of the company, what we’re trying to do, and the round.

GEN Edge: What is the effect of COVID-19 the last year and a half on Foresite building companies? What, if anything does Foresite do differently now than it wouldn’t have done two years ago?

Bajaj: Foresite was always set up for distributed and remote work. There is, though, no substitute for meeting in person, occasionally, so we have tried to balance that as the circumstances have allowed, to have creative, focused, and purpose-driven, in-person meetings, while also making sure that we’re able to work remotely, efficiently, with deep consideration of time zones and individual work preferences.

As a whole, we have adapted as well as possible given the bleak circumstances of the last two years. You know, the one bright side of working that way is that COVID has reminded us all that ideas are a global enterprise. And sometimes, the biases in the way that we use experience or geography as a proxy for judging those ideas really have been dismantled, because there are a far greater set of credible founders in an increasingly virtual playing field.

We feel now that we are competing for the greater set of founders, not the reverse. That alone is going to be a durable effect that will greatly increase innovation at a time of extraordinary transformation in our industry. Successful funds like ours have adapted to that, recruiting people who are experienced in all of these geographies and networks, who can relate to them better and really embrace the idea that innovation doesn’t come from Boston and San Francisco alone, but also from, all over the world, and all over the U.S.

GEN Edge: Looking ahead, how many companies do you anticipate Foresite creating and spinning out each year going forward? I’ve read where you said five companies in 18 months was a bit too much. What sort of a pace are you looking at?

Bajaj: The trend that you would see, without making a promise about this, is that we want to make sure that we are there for the companies that we have created already. So, the pace of new company creation will be slower. Those ideas, though, will be larger. They will involve the generation of data in the way that I was suggesting before—that really defines an area. And there will be things that we partner with and make an enduring commitment to for a long time. So qualitatively, I don’t think we’ll be forming as many companies every year as we have in the last two years.