Making Cancer Care Globally Accessible With Stephen Towe
Episode Summary
In this episode of The Cancer Project Podcast, host David Raubach sits down with Stephen Towe, CEO and co-founder of Leo Cancer Care, to explore one of the most ambitious missions in modern oncology: making proton therapy globally accessible. Towe, a physicist by training who entered medical physics after losing his father to cancer, traces his path from designing hardware at Elekta, including work on the MR-guided Linac, to leading a startup that is fundamentally reimagining how radiation is delivered to patients. His personal motivation is never far from the surface, and it shapes every strategic decision Leo Cancer Care has made since its founding.
The central innovation behind Leo Cancer Care is deceptively simple in concept but radical in practice: rather than rotating a massive gantry around a stationary patient, Leo’s system keeps the radiation beam fixed and moves the patient instead. This inversion of conventional design philosophy, developed initially by a research group at the University of Sydney led by former Stanford professor Paul Keall, strips away roughly 75% of the cost and mechanical complexity that has historically made proton therapy a technology limited to large academic medical centers. A conventional proton gantry stands 36 feet wide, weighs 100 tons, and must rotate with millimeter precision, a feat of engineering that demands enormous concrete vaults and equally enormous capital budgets. Leo’s approach collapses that footprint to something that can fit inside a standard linear accelerator vault, a goal that clinicians in the field once described as impossible.
Towe describes an unconventional journey from London to Sydney, and then from Sydney to San Francisco, each move driven by the need to find the right capital environment to bring the technology to market. When the original Australian entity ran out of funding and went bankrupt, Towe, who had no background in venture fundraising, Googled the top medical device investors, identified San Francisco as the hub, and relocated. After securing initial investment and determining that Madison, Wisconsin offered dramatically lower operating costs and an established supply chain from companies like Accuray, Leo set up operations there. Rock Mackey, an industry legend known for co-developing TomoTherapy and the Pinnacle treatment planning system, joined early as an adviser and board member, lending credibility to a company that most of the field still viewed skeptically.
The clinical case for treating patients in the upright position, sitting in a chair rather than lying on a table, emerged as a secondary but powerful benefit. Research from MD Anderson and Mark Pankuch at the Northwestern Proton Center had documented measurable reductions in organ motion when patients are upright, improving dose conformality. Sophie Towe, Stephen’s wife and Leo’s marketing director, gave this clinical reality a compelling human framing: people facing the most frightening moment of their lives instinctively want to be upright, engaged, and empowered, not lying flat on a table in a machine. Her campaign around “a more human way to deliver radiation therapy” drew on her background leading campaigns for McDonald’s and Volkswagen rather than on healthcare industry conventions, deliberately avoiding the homogenized messaging that tends to circulate when marketing directors move between radiation therapy equipment companies.
By 2025, Leo Cancer Care had accumulated 39 commercial contracts spanning proton therapy, carbon ion, FLASH electron radiotherapy, and conventional photon radiotherapy, a far cry from the 2018 Estro conference in Barcelona where Towe could not get a single customer meeting. The most significant recent milestone is FDA clearance for the Leo-Mevion FIT system, a partnership in which Mevion supplies the world’s smallest proton accelerator and Leo provides the rotating patient positioning system and integrated CT imaging. The FIT name reflects the system’s defining achievement: the entire proton therapy setup fits inside a linear accelerator vault. With installation complete at Stanford and state licensing underway, the first patient treatments are expected in 2025, closing a journey that began in a Sydney office the size of a single room.
What You’ll Learn in This Episode
- Upright Patient Positioning: Leo Cancer Care treats patients seated upright rather than lying on a table, keeping the radiation beam fixed while the patient moves, eliminating approximately 75% of the mechanical complexity and cost of a conventional gantry system.
- Proton Therapy Access Gap: Despite being considered the gold standard for treating many cancers, proton therapy has historically been inaccessible to most patients worldwide due to the enormous size, weight, and cost of conventional rotating gantries, which can weigh 100 tons and stand 36 feet wide.
- The FIT System: Leo’s partnership with Mevion produced the FIT system, the first proton therapy setup designed to fit inside a standard linear accelerator vault, opening proton treatment as an option for the thousands of existing Linac facilities that lack space or capital for conventional proton construction.
- FDA Clearance: The Mevion-Leo FIT system received FDA clearance in 2025, transitioning the technology from factory prototype to a device legally ready for patient treatment; a milestone Towe describes as a critical inflection point for commercial momentum.
- MR-Guided Linac Background: Before founding Leo, Towe was product owner at Elekta for the MR-guided Linac project, a system that combines MRI imaging with radiotherapy delivery, requiring engineers to solve the fundamental incompatibility between strong magnetic fields and radiation beam delivery.
- University of Sydney Origins: The rotating-patient concept originated with a research group at the University of Sydney led by Paul Keall, a former Stanford professor, who was initially trying to address cancer access disparities in rural Australia, where patients living outside Sydney and Melbourne are 30% more likely to die from cancer.
- Early Clinical Champions: Vincent Gregoire at the Centre Leon Berard in Lyon, France, and Mark Pankuch at the Northwestern Proton Center provided early external validation, Gregoire for his interest in bringing protons into a European urban center, Pankuch for his hands-on experience treating patients upright and his specific feedback on the practical challenges to solve.
- University of Wisconsin Contract: The first commercial contract in the U.S. came from the University of Wisconsin, where department chair Paul Harari had spent eight years trying to get proton therapy approved internally; a goal that always made clinical sense but never made financial sense until Leo’s lower-cost model changed the equation.
- Human-Centered Marketing: Leo’s marketing strategy, led by Sophie Towe, was built by deliberately hiring outside the radiation therapy industry, drawing on experience from consumer brands, to create messaging around treating patients as human beings rather than as cases, centered on the concept of empowerment through upright positioning.
- The Leo Name: Leo is the constellation that follows Cancer in the zodiac, chosen to reflect the company’s mission of always coming after cancer. The name also carries associations with lions, symbols of strength in many Asian cultures, aligning with Leo’s goal of expanding access in global markets.
- Organ Motion Reduction: Clinical research published by teams at MD Anderson and Northwestern demonstrated that treating patients in the upright position reduces internal organ motion compared to the supine position, which can improve the precision of dose delivery to the tumor and reduce exposure to surrounding healthy tissue.
- 39 Commercial Contracts: By 2025, Leo Cancer Care had signed 39 commercial contracts with end users across proton therapy, carbon ion therapy, FLASH electron radiotherapy, and conventional photon radiotherapy, reflecting the broad applicability of upright patient positioning across radiation modalities.
Stephen Towe’s story is a reminder that the most consequential advances in cancer care often begin not in a boardroom or a well-funded lab, but in a small office, driven by grief, physics, and the refusal to accept that a better approach is impossible. From his father’s cancer diagnosis to an FDA-cleared system now installed at Stanford, Towe has built Leo Cancer Care around a single conviction: that every patient, regardless of geography or the size of their local hospital, deserves access to the best available treatment. For anyone working in oncology, investing in healthcare technology, or simply living with the reality that cancer touches nearly every family, this conversation is essential listening.
Full Transcript
Read Full Transcript
Transcript generated from the episode’s audio. Speaker names are identified from the context of the conversation rather than from recorded speaker data, and automatic transcription may misspell names and terminology. Please refer to the video for the authoritative version.
David Raubach: Well, Stephen, thank you so much for joining us today on the Cancer Project podcast. I’m really excited to talk to you about all the great things that are happening with Leo, but also I want people to get to know you and your background as well, because I think it’s a really interesting story. So, thank you for joining us.
Stephen Towe: No, really appreciate it. Thank you for having me.
David Raubach: So tell us a little bit about your training and how you ended up in the world of proton therapy.
Stephen Towe: Yeah, so I’m a physicist by background. Got into physics really just for a love of figuring out how things work. You know, one of those annoying kids at school that’s always just, oh, why is it like that? Why is that? So I’ve always loved physics and, while I was studying physics at university, unfortunately my dad died of cancer.
David Raubach: Okay.
Stephen Towe: So I saw him go through what was a very difficult journey, and it was just an opportunity really, getting into radiotherapy, to use that love of physics. It’s a very physics heavy industry, and a passion of making a difference to cancer patients’ lives. So getting into developing technology originally, and then now running Leo Cancer Care.
David Raubach: So for those of listeners that are not familiar with how you end up as a medical physicist, what’s the training like to become a medical physicist?
Stephen Towe: Yeah. So you go first into university and study physics, the baseline physics, which is where I learned about particle accelerators and quantum physics as a particular passion. And then I would I trained in the UK rather than in the US. So then go and study specifically medical physics following that.
David Raubach: Okay. And so, and to learn about medical physics, what are you learning about?
Stephen Towe: Yes. There’s a lot of different elements there, but it’s a broad range of applications of physics within the clinical setting. So radiotherapy, radiology, you know, all of those areas of healthcare are heavy on the physics side.
David Raubach: What was your first job out of training?
Stephen Towe: So I went straight into Elekta.
David Raubach: Okay.
Stephen Towe: So for me it was, there was an opportunity to go into working in the clinic, and that would have been great, I’m sure I would have really enjoyed that. But I think for industry, working in industry, it gives you that broader impact possibility. You know, I can go and develop technology that is impacting millions of people, right? That always had a much stronger pull for me.
David Raubach: And so when you were with Elekta, what were you doing with Elekta? And I guess again, maybe for those not as familiar with some of these names that we’re throwing around: Elekta makes linear accelerators, and they also make treatment planning software, software that’s used to develop radiation treatment plans. They make a medical record system, Mosaic, that does the verification of the radiation dose that’s being delivered each day. So what, in that kind of broad spectrum of different parts of Elekta, what were you doing?
Stephen Towe: Yeah. So I was really working within their physics team developing the hardware platforms. So I’ve always been terrible with software, hate coding, which is a bit unusual for a physicist. So I was always on the hardware technology platform design. So things like designing calibration procedures specifically for the multileaf collimators, the bits that shape the radiation beam, all the way through to when I left Elekta being a product owner responsible for pretty much all of the physics activities that were on the MR guided linac.
David Raubach: Okay. So that was taking an MRI machine, putting it with a radiotherapy treatment platform.
Stephen Towe: Yeah. To create this combined imaging and treatment modality, which is super exciting cuz the goal with radiation has always been how do you get as much radiation to the tumor as possible and as little radiation to healthy tissue as possible. And so part of that, immobilizing the patient, part of that is designing different ways to deliver the beam of radiation.
David Raubach: Yeah.
Stephen Towe: Part of it is what radiation are you using? Are you using high energy photons or high energy protons? But part of it is the imaging. What can you see as you’re developing the treatment plan, and then what can you see inside the treatment room?
David Raubach: Yeah.
Stephen Towe: So yeah, that was an interesting project, merging MRI, which does give a good view of what’s happening inside the body, with the actual delivery of radiation. But there are two things that really don’t go together. MRI and radiotherapy, like almost putting oil and water together, because the MRI will interfere with radiotherapy delivery and the radiotherapy delivery will interfere with the MRI imaging. So it’s it really is something those two things shouldn’t sit in the same room, which, as a physicist, then that’s really exciting, fun projects to work on.
David Raubach: Yeah. So then you ended up leaving Elekta for different opportunities. So tell us about that transition.
Stephen Towe: Yeah. So I came out of Elekta and really got to the end of that project, and while I was really excited and proud of the product that we’d developed, I couldn’t help but see it was bigger than conventional radiation therapy. It was certainly more expensive, but it was also more complicated than conventional radiotherapy, required more people in the treatment rooms, and they required more training to be able to use an MLC, and that didn’t really fulfill the dream of how do we make radiotherapy available across the globe, which is something that’s always been important to me.
Stephen Towe: So then I became aware of a research group down in Sydney, in Australia. Never been to Sydney before. But led by Paul Keall, who used to be a Stanford professor and then he moved back to the University of Sydney, and they were looking at exactly that. How do we make radiotherapy globally accessible? How do we reduce the costs and get it to more people, right? And they came to the realization that the way of doing that is to keep the radiation beam fixed and to move the patient instead.
David Raubach: Okay.
Stephen Towe: Everybody else previously, in radiotherapy development, had the patient lay on a table and moved the radiation beam with respect to that patient. These guys were really bold in their thinking, in saying, well, that movement of the radiation beam accounts for probably 75% of the cost.
David Raubach: Okay.
Stephen Towe: So if we change that and flip it on its head, and we instead move the patient, now the costs and the complexity come down.
David Raubach: Okay.
Stephen Towe: So they got in touch with me and said, “We’re looking for people that have got industry experience, that have developed products, not just ideas, to come join this group and start building this out into an idea that could be productized and commercialized.”
David Raubach: Okay. And you’re in England at this time?
Stephen Towe: I was in London. Yeah, I was in London at that time.
David Raubach: So then did you move to Sydney?
Stephen Towe: I did.
David Raubach: Wow.
Stephen Towe: Yeah, I did. Never been down there before. Even if the job opportunity hadn’t have been great, the idea of living in Sydney for a year and a half was pretty fantastic. So yeah, packed up my bags and moved to Sydney.
David Raubach: Okay. And were you married at this time? Kids?
Stephen Towe: No, not — that was a lot easier to do. A little bit easier to do when it’s, yeah. So not married. I’d, my wife Sophie, had known her for about 6 months at the time.
David Raubach: Okay.
Stephen Towe: So I remember taking her for dinner and saying, “Hey, Sophie,” and we’ve only known each other for 6 months, but I’m thinking about moving to Sydney. And she went, “Oh, I’ve always wanted to go to Sydney. I’ll come with you.”
David Raubach: Oh, wow.
Stephen Towe: Yeah. Oh, so she went.
David Raubach: Okay. So, you get there. What was it like, kind of, that early stage? I mean, Elekta is a big company. They’ve got a lot of resources, offices. They’ve been around for a while. This was like a startup, I mean, this is a quintessential startup.
Stephen Towe: Yeah, the office was about the same size as the room that we’re in today, with the entire team.
David Raubach: Yeah.
Stephen Towe: And yeah, it was a big difference. No processes, no people, no, you know, no big established office. It was a big difference.
David Raubach: Yeah. What was it like for you, jumping into that?
Stephen Towe: It was exciting, but it was also pretty terrifying.
David Raubach: Okay.
Stephen Towe: Yeah, it was, you know, going from having people that did everything at Elekta to now having to figure out how to do all of that yourself.
David Raubach: Yeah. So, when you guys were talking about doing upright treatments, is that just for photons, or were there conversations about how it might be applied in the proton space?
Stephen Towe: Yeah. So, actually originally it wasn’t in the upright orientation, so that’s where we are today, treating patients upright. But the original idea was to have them lay down still and rotate them in the supine orientation.
David Raubach: Oh wow.
Stephen Towe: But it was all for photons. So the reason that group started is because they were trying to address the access, or the lack of access, to conventional radiotherapy in rural Australia.
David Raubach: Okay.
Stephen Towe: So you’re 30% more likely to die from cancer if you live outside of Sydney and Melbourne.
David Raubach: Okay.
Stephen Towe: Which in a country like Australia is pretty, pretty shocking.
David Raubach: So I mean, it’s a first world country.
Stephen Towe: Yeah. Yeah. So they were looking at putting these supine, rotating linacs in trucks and taking them out to rural Australia. That’s where it started.
David Raubach: Oh wow.
Stephen Towe: And then realized, it’s the difference between academia and an idea, and industry, where you have real patients that are going to use these machines. The idea of supine rotation, while it was great on paper, didn’t actually make sense then, in reality. So that was then the transition to upright.
David Raubach: Okay. Was that because the idea of supine didn’t work?
Stephen Towe: Okay. Yeah. Yeah.
David Raubach: It’s interesting because, you know, being more on the clinical side, there’s a lot of things that sound good, and then you realize that you’re dealing with people.
Stephen Towe: Absolutely. And people come with a lot of variability and a lot of needs that a part does not.
David Raubach: So, then you guys started working on an upright concept then?
Stephen Towe: Oh yeah. Yeah. So, that realization that, in order to rotate, you have to be upright, was made in Australia. And then we started realizing, once we’d got our heads around that, that people from MD Anderson had looked and researched upright radiotherapy, Northwestern Chicago, and they’d proven out some pretty interesting clinical differences, so organ motion reduction, things like that, that happen when you’re upright rather than lay down. So the story kind of came together nicely, but it was still focused on photons originally, still looking at how do we build these smaller, smarter, more effective linacs.
David Raubach: So, I think, with that project, and we’ve talked about this before, you know, there’s also, with academia versus industry, there’s also a fundraising component, and just, like, how do you get a product to market element. You know, you have to hire people, and you have operating costs and research costs. And so, talk a little bit about, you’re moving out of this medical physics world, very science oriented, and you’re starting to pick up on the business element of getting a product to market. I mean, when did that start to become interesting to you, or did you really start to think about that?
Stephen Towe: Yeah, it was never, certainly never my plan to become a CEO. It was certainly never my plan to go into the commercial side of things. I always wanted to stay in industry and design technology. But in Australia, as we started to build out this idea, you’re exactly right, you need to raise money, and you need to find investors that believe in your vision. And in Australia, that was a real challenge. It was a real challenge. Venture capital didn’t really invest in healthcare and in medtech, right? Back then, it’s improved significantly since then, but yeah, it just wasn’t there. So the company, actually, in its original form, went bankrupt.
David Raubach: Okay.
Stephen Towe: So it was not a grand design, a grand plan, to go and learn how to raise money, but it was more out of necessity. So, with nobody else being in a position where they wanted to leave Australia at that point, I said, “Well, you know, I’ve been spending years designing linear accelerators, how hard can it be to go and raise money for them?”
David Raubach: Right. Right. Right. Right. Right.
Stephen Towe: So, yeah. How wrong could I have been?
David Raubach: Yeah. And so then, did you leave Australia at this time?
Stephen Towe: Yeah.
David Raubach: Okay.
Stephen Towe: Yeah. So at that point I genuinely Googled top 10 medical device investors and saw San Francisco.
David Raubach: San Francisco. San Francisco.
Stephen Towe: Yeah. So that was it. If I believed in what we were doing and believed in the company, I knew that I had to pack up my bags again and leave Sydney.
David Raubach: So, you go to Sophie. Are you guys dating, married at this time?
Stephen Towe: Well, I was very, very strategic. I thought, okay, it’s not ideal that I’m going back to her again and asking her to move everything and relocate. So, we got engaged before I asked her that time. So she had agreed to marry me, so she was already committed there. And then I went back and said, “Okay, to make this work, yeah, we need to, we need to Sydney.”
David Raubach: Yeah. By the way, now you’ve said yes.
Stephen Towe: Yeah. We need to leave Sydney and move to San Fran.
David Raubach: Okay. And so, what were the early days there in San Francisco? Like, so, somebody’s trying to raise money, you’ve never done this before. What are you doing?
Stephen Towe: That’s kind of what I was asking myself on a daily basis. What on earth am I doing here? And it’s just going and meeting as many people as you possibly can. Networking like you’ve never worked before, getting feedback, asking people why they’re saying no, and trying to understand how your pitch needs to change in order to start getting some of those yeses. So it was just meeting hundreds of people over the course of probably the first 3 months while I was there.
David Raubach: Okay. Yeah. So, you’re sending emails, you’re going to networking events, you’re knocking on doors.
Stephen Towe: Literally walking into companies.
David Raubach: Yeah. Yeah. That’s amazing. And so, describe that moment when you finally got the first Yes.
Stephen Towe: Yeah, it was a pretty epic feeling. You know, when somebody’s really decided to invest, they’ve bought into your vision, it’s not only that they’ve decided to put the money in that allows you to continue, but it’s the feeling of knowing that somebody else buys into your vision. If you’re the only one out there pushing something, then you kind of feel like, is this a good idea? Am I crazy? Once somebody looks at it and says, not only does that idea make sense, but you actually have a business that makes sense as well, so it’s a great feeling, absolutely fantastic feeling.
Stephen Towe: And then, once we got the first one, raising money is really, you know, it’s about getting momentum behind it. So once you get one person buying into it, then you tend to be able to get multiple.
David Raubach: And so what were you raising money for at that point?
Stephen Towe: So we were, at that point, really raising money to start building out the design, hire people, pay for parts to build early prototypes, and then, as well as, you know, some of the more obvious things like rent, bills, the standard sort of stuff.
David Raubach: And were you, so were you thinking that you’re going to move operations to the US as well? Was that part of the process of going to San Francisco and raising the money, that the core of the team is going to move to the US?
Stephen Towe: Yeah, absolutely. It was really, you know, let’s relocate everything, let’s move to San Francisco.
David Raubach: Okay.
Stephen Towe: And let’s build out the business here. That was absolutely the plan. Didn’t quite go to plan.
David Raubach: Yeah.
Stephen Towe: But that was definitely the intention.
David Raubach: Okay. And when did Rock Mackie get involved, or how does he come into the story?
Stephen Towe: Yeah. So Rock, I mean, Rock is an industry legend. He’s such an innovative person. He’s changed the industry a couple of times with tomotherapy and the pinnacle treatment planning system. So he was actually involved in Australia, so when the research group was developed and decided to spin out as an entity, Rock was originally an adviser, and then joined the first board of directors in Australia.
David Raubach: Okay. And so you moved to the US, and then how did you end up in Wisconsin? Was that because of Rock?
Stephen Towe: Yeah. So when we started getting some traction, and the first investors coming in, then it was sort of a, “Oh okay, this actually looks like it’s going to happen” moment. And I put more time and effort then, at that point, into focusing on the business plan and exactly how we’re going to build. And we realized, you know, it was just so expensive to build a business in San Francisco, right? So if we built the business in Madison, which is where Rock lives, but also where companies like Accuray have been built, so there’s good supply chain, there’s good talent there, the cost of hiring people in Madison was, you know, 40, 50% in some cases lower than San Francisco.
David Raubach: Okay. And so, at what point during this process do you start really honing in on this patient positioning system, which we’ll get into the details of what the product is, or what the products are? When did you really start to hone in on this being a proton therapy product?
Stephen Towe: Yeah. So again, remember, you know, the big reason initially for rotating the patient rather than the machine was to reduce the size, the cost, and complexity, and that’s a problem for conventional radiotherapy. But as we engaged with industry experts, they kept saying, well, yes, it is a problem for conventional radiotherapy, but protons is a massive issue. You know, protons, there was no access, or very limited access, worldwide for a technology that is really the gold standard for treating cancer, and the reason for that lack of access was always size, cost, and complexity. So we realized that, you know, to solve the problem in linacs could wait, we would go and address this issue with proton therapy first.
David Raubach: Yeah, I mean, when we talk about a gantry, like the gantry that we have at our facility, so that’s the device that actually can rotate 360° around the patient, deliver protons at any of these different angles into the patient. Our gantry is 36 feet wide and weighs 100 tons.
Stephen Towe: Yeah.
David Raubach: So if you think about, I mean, that’s three stories, 36 feet. You’ve got to shield it. So you have this massive concrete bunker that it sits in. Then it weighs a 100 tons, and that whole thing has to rotate with millimeter, or even micron, precision around a patient. It’s it’s it’s the most complex medical device that’s ever been made, I would say.
Stephen Towe: MR-linac may be a close second.
David Raubach: And so yeah, it’s definitely, it’s just cost prohibitive to put those in every market that really could benefit from proton therapy.
David Raubach: So you guys start to develop this product. What were some of the really big challenges early on, as you’re honing in on this being what’s going to be your first commercial product? What were some of the things that maybe even made you say, did we make the right decision here?
Stephen Towe: Yeah, it was always, for us, it was less of a technical challenge. You know, we were actually simplifying the technology tremendously. So the big hurdles for us to overcome, it was never about developing the technology, we were always confident we could do that. But we are making a bold change, and generally, as humans, we don’t like change, you know, it makes us have to really think about things and make sure that we’re confident we’re doing the right thing.
Stephen Towe: So we had to go out and convince early customers, you know, because investors look at commercial traction and say, “Show me people that are interested in buying this.” So before having anything, before we’d built anything, we had to go out and engage with early customers that have always done things in the supine position, right? Convince them that upright had a place and it could work. And that’s really tricky, you have to have a tremendous amount of passion and conviction in what you’re doing.
David Raubach: Who were some of the early champions for you that you would give credit to, to say, “Okay, well, this is,” maybe obviously internal, you guys are on board with this idea of moving a patient from laying on their back or laying on their stomach to sitting in a chair. Who were some of the people outside of the company that came alongside and said, “No, this really can work”?
Stephen Towe: Yeah. So, I mean, the very, very first research partner that we engaged with, that started working with us, was a guy called Vincent Gregoire.
David Raubach: Okay.
Stephen Towe: Who’s based over in Lyon, in France. So he had always wanted to put protons into that center, and came across the same problems, gantries are really big, they’re expensive, it’s very difficult to do that in a European city. So, you know, when I first met him back in 2019, he just got it instantly. And he’s, you know, he’s one of these people where if you tell him something can’t be done, he doesn’t want to run away from that, he’s more likely to want to do it. So you need those kind of brave, committed people on board to help drive change.
David Raubach: So that’s in France. What about in the US?
Stephen Towe: So, France, in the US, we, you know, we got a lot of feedback from people like Mark Pankuch. So Mark Pankuch, up at the Northwestern Proton Center, he’d been treating patients upright at this point for his thoracic tumors. So he understood the benefits, he understood why we were doing what we were doing. But he was also able to say, these are all the reasons why I’ve struggled with it, and these are the things, if you’re going to start from square one, try and fix this problem, this problem, and this problem. That was really, really helpful.
Stephen Towe: And then we got support from places like MD Anderson as well, that had published data on the benefits of upright, and the first center that started working with us and executed a commercial contract in the US was the University of Wisconsin.
David Raubach: Okay.
Stephen Towe: Paul Harari, who was the chair there, tried for eight years to get proton therapy into his department. He’d been to the board with multiple different proposals and said, “Hey, we need protons.” With the University of Wisconsin, let’s try and find a way of doing this, and it had never worked financially. Always worked clinically, made sense from a clinical point of view, but the finances never made sense.
David Raubach: Right. And so, I do want to talk about somebody that you brought onto your team that I know really well, Nick Schroeder. He helped build, and I’ll never forget this because I worked at the proton center in Oklahoma City, and here’s this kind of eccentric South African who had helped build a proton system in South Africa and then he was at IU, and that’s essentially an in-house system that was built there.
David Raubach: So he had this, he always had this idea of, kind of like the doctor you were talking about in Lyon, that if somebody says it’s impossible, Nick’s going to take it on and he’s going to say it’s not impossible, we’re going to figure it out. And so we built that chair in Oklahoma actually first, even before Chicago. And we still have it upstairs in our mezzanine, and it was very rudimentary, I mean, it almost felt like it got built in a garage. But it worked. I mean, we could attach it to the Forte robot that was in the room and treat patients sitting in this chair, and then Chicago kind of took it to the next level with Mark’s leadership. So, talk a little bit about Nick and kind of what he’s brought to Leo.
Stephen Towe: Yeah, Nick, he’s just the most practical genius that you’ve ever come across. So, I’ve met lots of really smart people that can come up with ideas. I think the amazing thing about Nick is, you know, you come to him with a problem, you say, “Nick, I’m worried about quality assurance, for example, and how we’re going to do that.” And not only is he going to turn around and say, “Don’t worry about the problem, because here’s how we approach it,” but he’s also going to turn around and go, “Oh, and by the way, I’ve built that solution in my shed. And I’ve also found a supplier who can build it commercially as well.” So he’ll never shy away from any challenge. He’s incredibly passionate about two things in life, proton therapy and barbecue.
David Raubach: True.
Stephen Towe: Yeah. And he brings, you know, he just brings so much passion into it, and he raises his own meat and butchers his own meat.
David Raubach: Yeah. This is not like catering in barbecue, this is him.
Stephen Towe: Yeah. Start to finish, doing his own barbecue.
David Raubach: Yeah. That’s—
Stephen Towe: Yeah, that’s funny.
David Raubach: Now, Nick is great, and I know you have a lot of great people that work for Leo. Where did the name come from? So, Leo, talk a little bit about that.
Stephen Towe: Yeah. So, Leo is the constellation that comes after cancer. So, as an organization, that’s our mission, we’re constantly coming after cancer, we’re constantly trying to find ways of developing technology that will treat cancer patients. So, that’s where it came from in that sense. It’s also associated then with lions, which particularly over in places like Asia, are associated with, you know, a figure of strength. So bringing those two things together, we got Leo Cancer Care.
David Raubach: And one of the things that you guys have, you guys have done a great job with your marketing. And I know that you take all the credit for that. But no, seriously, that’s actually, you know, you made a great decision getting engaged to Sophie and convincing her to move to San Francisco, but then you also made a great decision bringing her on to help with the marketing for Leo. And I loved what you guys have done with some of your campaigns talking about creating a more human way to treat cancer. So, talk a little bit about that, and what she’s brought to the company, and just the vision for how you guys have marketed Leo.
Stephen Towe: Yeah. So, we made a very conscious decision that within our marketing team, we wouldn’t put anybody in there that was already in the industry. So, you know, you tend to go around the other providers of radiation therapy equipment, and it’s the same marketing directors, chief marketing officers that go from company to company, and you can kind of tell then that the messaging all looks and feels very much the same. We didn’t do that. We looked at it and said, I don’t need more industry radiotherapy knowledge to come from my marketing team, what I need is people that are really good marketers, I need people that can take the powerful message that we’ve got and can communicate that well. Industry knowledge can come from people like Rock and Keall, and, you know, there’s nobody better out there than those two to provide that industry knowledge.
Stephen Towe: So Sophie had been leading campaigns at McDonald’s and Volkswagen, you know, companies like that, that are much more, you know, targeted with their marketing, and frankly better at putting forward their messaging than a lot of healthcare organizations. So we put her in our marketing director position, and she’s just done a wonderful job. It helps, I think, in many ways that she doesn’t have that industry expertise, she’s much more likely to come and say, “Well, why have we done it like that?”
David Raubach: Yeah.
Stephen Towe: And actually, if you get challenged like that and questioned, it’s often, you sit there and go, “Well, yeah, if I can’t give you a solid reason of why it’s like that, let’s look at it and question whether it needs to be that way, right?” But yeah, the whole idea of being a more human way to deliver radiation therapy, that was her baby, that was her idea. And it came from this idea of, you know, human beings, when we put them in the radiotherapy environment, whether it’s protons or photons, that is, without a shadow of a doubt, the scariest moment in their life. You know, they’ve never been through, most people, anything more scary than being treated for cancer, right?
Stephen Towe: So then we started thinking about other times that people are scared. You know, and if you think about giving a big presentation, a job interview, meeting in-laws for the first time, you name it, anything that makes you anxious, you wouldn’t choose to do it lying down, right? You’d always choose to be upright, engaged, and empowered, and part of that process. So what we realized is that by putting patients back at the center of their care and putting them upright, we were doing exactly that, we were empowering them and making them feel more human, and giving them that humanity back at the time where they were really being referred to as just patients.
David Raubach: Yeah, that’s great. So, now let’s transition to the product itself, or products, I guess, because there’s a lot of exciting things happening from a development standpoint. So, you guys have had a couple of big announcements recently, talk a little bit about what’s happened over the last 12 months with Leo.
Stephen Towe: Yeah. So, I mean, we really started from a point of view of everyone saying it was crazy. Everyone said it was a terrible idea, and it was never going to work, in 2018. I remember going to ESTRO in Barcelona, and nobody wanted to meet, there was no opportunity to sit and meet with customers or vendors. Everyone just thought it was a crazy idea.
David Raubach: I would like to go on record and say that I did not think it was a crazy idea early on.
Stephen Towe: So, yeah, that’s true. Actually, you’ve always been incredibly supportive. But yeah, it was really difficult back in those early days to get traction and get it moving.
Stephen Towe: So, to see it now, go from 2018, crazy idea, to 2025, we’re now in a position where there’s 39 commercial contracts.
David Raubach: Amazing. Wow.
Stephen Towe: With end users across not just protons, but protons, carbon, flash electron radiotherapy, and now for conventional photon radiotherapy as well.
David Raubach: Yeah, that’s amazing. And talk about your partnership with Mevion, because there was just a big announcement about FDA approval for the Mevion FIT system.
Stephen Towe: Yeah. So, as a, you know, as a hardware company, to get an FDA, I know a lot of people were waiting for that to come through, is a big relief, but that is huge. That takes it from an idea, and something built in the factory, to now something that is ready for treating patients. So that was a huge announcement for us, and a huge announcement for our partners at Mevion as well.
Stephen Towe: So the way that partnership works, you know, proton therapy relies on having a few different things. You’ve got the bit that produces the radiation, the proton source. Then you’ve got to deliver that proton source to the patient, so that’s where we have our rotating patient positioning system and our integrated CT imaging, right? So the partnership with Mevion is really that they provide the accelerator, and they’ve been doing that for many years, it’s the smallest accelerator anywhere in the world for proton therapy. And then we provide the patient positioning and the imaging. And the combination of all of those components gives us what we call this FIT product.
David Raubach: And the FIT, that name comes from the fact that that whole setup can fit inside of a linear accelerator vault.
Stephen Towe: Exactly that. Yeah.
David Raubach: And that’s really been the holy grail. I mean, we used to talk about that at ProCure, back when I was working there in 2010 and 2011, and we were trying to figure out how to commercialize proton therapy and make it more accessible to more patients. And we would, and it half jokingly, honestly, at the time, well, you know, if you could ever figure out how to put it in a linac vault, that would be the way that you could create more access, because there’s 4,000 plus linear accelerator vaults in the United States, and you always have to go and build a big new gantry vault. There’s just going to, that’s just going to eliminate a lot of customers that either don’t have the space or don’t have the funds to undertake this big new construction project.
Stephen Towe: Exactly. Yeah. And people said it was impossible. People said it was completely impossible, never happened, to put protons inside of a linac vault. And Mevion’s been a, you know, a phenomenal partner in sharing in that vision of, let’s make protons accessible to all, not just big academic medical centers.
David Raubach: So now we’re in a position where, you know, with 200 people went to Stanford during this show.
Stephen Towe: That’s amazing.
David Raubach: Yeah. To go and see that it’s real, this impossible task has been achieved with Leo Cancer Care and with Mevion. And they’re supposed to go live when, this year?
Stephen Towe: Okay. Yeah. So systems FDA cleared, fully installed. They’ve got some state licensing to get pinned down, but yeah, they should be treating this year.
David Raubach: That’ll be a big day. That’s a long journey from a workshop in Sydney to Stanford treating the first patient on this system.
Stephen Towe: It sure is. Yeah.
David Raubach: So what are you personally most proud of?
Stephen Towe: Yeah. I think most proud of, you know, the team that we’ve built and what they’ve been able to achieve. You know, we’ve got a lot of people, our VP of engineering, for example, he never went to university, never got a degree in engineering. He went into industry as an apprentice, one of the smartest people I know, really, really smart guy, but got pigeonholed into a position where it was, you know, you can’t be responsible for developing anything because you’ve not been to university, right?
Stephen Towe: The fact that he’d spent years and years and years actually being hands-on and developing this, he was always pigeonholed to a role without responsibility. And at Leo, we brought him in and we said, “Not, show us the paperwork that you’ve got that proves you can do this, but actually go and deliver,” right? And to see him now leading our engineering team, with tremendous engineers in that team, but we’ve created an organization that allows people to come and really fulfill their full potential. So, seeing people grow like that and develop in their profession, that’s something that I’m incredibly proud of.
David Raubach: Yeah, that’s neat. So you’ve created an amazing product, but then you also have this team of people that you’re impacting, and I think as a leader, you always want to see that and be a part of that. How have you taken the experience that you had with your dad going through cancer treatment to what you’re doing today? I mean, that’s obviously something that was very, very personal, and that must impact the way that you approach what you’re doing with your company today.
Stephen Towe: It definitely does. Yeah. My dad was, you know, a superhero to me, he was the best human being, still to this day I’ve ever met. So, being in a position where we’re developing technology that can make a difference to lives like his, you know, we couldn’t do it for him, but to be in a position where we’re making a difference to other patients like him is the driver.
Stephen Towe: And I think when you’re, you know, when you’re building a company, it’s hard, it’s really, really hard. You get days where you don’t think it’s going to work. You get days where people say they don’t believe in it. You get days where people don’t want to fund it. And I think if you’re motivated just financially, it just doesn’t work, you’ll bail, you know, you’ll walk away from the difficulties that you have, nine times out of 10, with startup companies. So for me, it’s always been about something just so much more important than money.
Stephen Towe: You know, we’re not building a business here just to build a business and to be financially successful. We’re building a business because throughout our organization, you see people that have been directly impacted by cancer.
David Raubach: Yeah.
Stephen Towe: You know, people that have lost loved ones to cancer. So, for us to be able to go and take something like proton therapy, that truly has the ability to save lives, and take it to places that it’s never been before, that’s a reason for getting out of bed in the morning.
David Raubach: Yeah, that’s amazing. Well, thank you so much for your time, Stephen. I really appreciate it. Congrats on all of your success, personally and with the company. You guys are doing amazing things. And as someone who’s been in the proton field for 15 years now, I’m very excited to see this amazing technology create more access for patients to get proton therapy. And I know that you guys are also doing some great things on the linac side, and you’re going to open up, really it was kind of the original vision, open up rural, or third world, markets to the power of radiation in treating cancer as well. And so, I’m excited to see what’s ahead.
Stephen Towe: Wonderful. Thank you very much, David.
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