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“They Told Me It Was Impossible And I Did It Anyway” with Dr. Rafi Hofstein

Make sure that the underlying hypothesis is evidence based. Many years ago I assisted in the development of a blood test for psychiatric disorders. The preclinical data were not powerful enough and yet we went ahead with human trials. We failed! As a part of our series about “dreamers who ignored the naysayers and did […]

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Make sure that the underlying hypothesis is evidence based. Many years ago I assisted in the development of a blood test for psychiatric disorders. The preclinical data were not powerful enough and yet we went ahead with human trials. We failed!

As a part of our series about “dreamers who ignored the naysayers and did what others said was impossible”, I had the pleasure of interviewing Dr. Rafi Hofstein.

Dr. Hofstein came to Toronto from Israel in 2009 to assume the position of President & CEO of a newly formed organization called MaRS Innovation, recently renamed Toronto Innovation Acceleration Partners (TIAP). At this position, Dr. Hofstein led the creation of more than fifty start-up companies primarily in the healthcare space. Among the companies of primary note are Triphase, Fibrocor and Notch Therapeutics in which Dr. Hofstein has been a co-founder and a director. In addition, Dr. Hofstein is a member of the Board of Directors of several not-for-profit organizations in Quebec and Ontario.

Prior to coming to Canada, Dr. Hofstein served as the President & CEO of Hadasit (the technology transfer company of Hadassah Medical Center, Jerusalem) and the chairman of Hadasit Bio-Holdings Ltd, a holding company listed on the Tel-Aviv Stock Exchange. One of the companies Dr. Hofstein co-founded and serves as a board director is BiolineRx, an Israeli biotech company listed on NASDAQ.

Dr. Hofstein received his Ph.D. from the Weizmann Institute of Science (Rehovot, Israel) and his postdoctoral training at Harvard Medical School. Dr. Hofstein also had a long tenure in the IDF and retired as a colonel after serving in the reserve troops for more than twenty years.

Thank you so much for joining us! Our readers would love to ‘get to know you’ a bit better. Can you tell us your ‘backstory’?

It was 2008 when our 26-year old daughter was diagnosed with stage 4, Acute Myeloid Leukemia (AML). Doctors tried everything but failed and she rapidly deteriorated and passed away. It was during the eight months of sitting at her bedside, feeling useless and frustrated, that I decided to redirect my career and focus on developing medical treatments that would rescue the lives of other young people.

I accepted a job to create and lead the efforts at Hadasit, the technology transfer center at Hadassah Medical Center, the leading research hospital in Israel.

For ten years, I helped to transform lab discoveries into companies. It was also during this time that we broke ground and opened a new building to house all of these budding young companies as well as list Hadasit on the Tel Aviv Stock exchange. Then, out of the blue one day, I received a call from Toronto asking me to come and duplicate what I had successfully achieved at Hadassah, for a consortium of universities and hospitals in Toronto, Canada.

I accepted the challenge, moved to Toronto and enjoyed a wonderful decade assisting the Canadian community heading up MaRS Innovation, aka TIAP.

Among the various things I was involved in and am proud of is being able to share my decades of experience in technology transfer to benefit organizations around the world. For example, from 2016–2020, my team in Canada trained teams in Seoul, South Korea on best practices of advancing the outcome of healthcare related research into promising medical treatment. The model established in South Korea, is currently being emulated by The University of West Indies, Jamaica. I find it very exciting and fulfilling that our technology transfer model is not only catching on and but also, and more importantly, helping scientists worldwide to more methodically and efficiently advance their medical discoveries into practice.

Allow me to elaborate: our model of operation stands out from the rest by virtue of our unique approach to vetting and advancing technologies and products from an infancy stage, even before the prototype, when it’s still simply an idea. Moving an idea at such an early stage up the value chain, requires a tremendous amount of creativity and courage. These are the qualities inherent in my various teams, from Jerusalem to Toronto to Seoul, and it has been a privilege to work with them.

This brings us to today. After a successful tenure, I recently passed the baton at TIAP and am now pursuing other initiatives.

Are you working on any new or exciting projects now? How do you think that will help people?

I am working on three types of exciting, medical-oriented projects, all with the goal of helping scientists to ultimately find cures for previously untreatable diseases and help patients to survive and gain a better quality of life.

I am currently working on a new initiative that connects Israeli innovation with partners in North America.

I am also an active director on the board of several biotech companies. These include BiolineRx, Notch Therapeutics and Fibrocor Therapeutics.

Thirdly, I am a volunteer board member of several not-for-profit, healthcare-oriented, Canadian organizations. In this capacity, there is an opportunity to share my decades of experience to benefit the next generation of scientists and decision makers. Each generation furthers the next. It is a joy to share my learnings to give the next generation a bit of a head start.

In your opinion, what do you think makes your company or organization stand out from the crowd?

It’s more about having created a working model than about any particular company or organization. We asked ourselves: how can we accelerate the process of mobilizing great ideas from academic research (aka “ideation”) to a more advanced stage of technology and product development? The key driving impetus is, that in healthcare research, time is of the essence. The faster we get innovative solutions in the hands of clinicians, the faster it is offered to patients whose lives are dependent on it.

The classical approach for technology transfer, which essentially relies on the out licensing of intellectual property, is a broken, anachronistic paradigm. Conversely, creating companies as a business platform for accelerated advancement of technologies has proven to be a much more effective alternative. This is the school of thought in which I am a pioneer. I have created over fifty startup companies. Some made it, others didn’t, which is a natural. Those that have made it are growing nicely and eventually will show return on investment.

Ok, thank you for that. I’d like to jump to the main focus of this interview. Has there ever been a time that someone told you something was impossible, but you did it anyway? Can you share the story with us? What was your idea? What was the reaction of the naysayers? And how did you overcome that?

All along I have encountered naysayers and skeptics. Twenty years ago, it was quite revolutionary to build a portfolio of startups under the umbrella of a technology transfer office. I did it first at Hadasit starting in 2000 and at TIAP during the last decade. I heard everything from “why do you think an academic institute should be actively involved in something like this?” to statements about capability to identify the right talent to come and manage these infant companies, as well as strong skepticism that we would ever be able to raise even seed funds.

The way I overcame the massive layer of skepticism was by focusing on getting things done. Then, after several demonstrable successes, accompanied by proof that we knew how to mitigate potential risks, the support from the stakeholders finally came.

An example: together with one of the member institutions we created a partnership focusing on innovative approaches in oncology. That partnership led to the foundation of a company called Triphase. Soon thereafter, we started the search for a transformational new treatment for cancer and for significant funding. Both came along by virtue of a very unique partnership with Celgene (now part of Bristol Myers Squibb). With very significant financial support from Celgene we started the development of a new drug for the treatment of glioblastoma (brain tumors). The development process has since transferred to Celgene, which is now conducting the phase III clinical trial. This was declared by our stakeholders as a major success and dropped all walls of skepticism.

In the end, how were all the naysayers proven wrong?

Well, after twenty years of demonstrable success, not only were the naysayers silent, many of them became proponents and have adopted a similar approach to the acceleration process. Namely, it has become common practice for many academic institutions to be actively involved in company creation.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

Mary Jo Hadad clearly stands out. At the time, she was President and CEO of the Hospital for Sick Children in Toronto and the inaugural chairman of the Board of Directors at MaRS Innovation. I came from Israel in 2009 and needed to quickly adjust my temperament to the Canadian style. Mary Jo coached me in a very gentle and elegant way how to captain the ship without threatening my peers and clients.

It must not have been easy to ignore all the naysayers.

While I was getting ready to take Hadasit public on the Tel Aviv Stock Exchange as Hadasit BioHolding, an individual, who was prominent in Israel’s economy and involved in the commercialization affairs of a leading Israeli academic institute, shared his skepticism with me about the move. This person argued that an academic institute had no place on a stock exchange and predicted that it would fail. A year later, this person did something similar.

Did you have any experiences growing up that have contributed to building your resiliency? Can you share the story with us?

While growing up, at the age of 6, I got sick and was diagnosed with rheumatic fever. As imaging technologies evolved, it became clear that the disease left me with a damaged heart valve. Everybody, including physicians, family and friends recommended, as a safety precaution, to adopt a lifestyle of total protection, almost like being surrounded by cotton wool. My response: not happening! From then on I ran a normal life including Israel Defense Force military service in a combat unit. I kept reminding myself that I had a murmuring heart. But from this, evolved a great sense of resiliency.

Based on your experience, can you share 5 strategies that people can use to harness the sense of tenacity and do what naysayers think is impossible?

1. Make sure that the underlying hypothesis is evidence based. Many years ago I assisted in the development of a blood test for psychiatric disorders. The preclinical data were not powerful enough and yet we went ahead with human trials. We failed!

2. Spend enough time to ensure that there is a need for the resulting product (in pharma jargon: UMN). In Triphase we developed a druggable molecule called Merizumib and assumed that it should target multiple myeloma. Celgene, our partner at the time, felt that this particular molecule should be developed for glioblastoma. It is now in a phase III trial for glioblastoma being managed by Bristol Myers Squibb.

3. Make sure that there is a solid coalition of key opinion leaders (KOLs) ready to confirm the legitimacy and probability of success. One of our companies, Encycle, focused on GI tract disorders and relied on a leading Canadian scientist as an advisor. The company was successfully acquired recently and the first thing the acquirer did was to contact the scientist to get his opinion. With his blessing the transaction was successful.

4. Make sure that there is sufficient capital to support the development; assume that troubleshooting is required along the journey which adds to the cost. I can share many stories of great ideas that went nowhere due to the lack of sufficient capital at the seed-stage, which prevented the safe crossing of the infamous “valley of death” (aka chasm) of drug development.

5. Make sure to recruit highly skilled and well-trained teams to ensure professionalism throughout the process. Founding scientists are very protective of their ‘baby’ and it has been an everlasting struggle to explain to them that, although that ‘baby’ and the full credit remains theirs, the upbringing requires another skillset. I can state with full conviction that in all cases where we ‘were allowed’ to recruit well-trained teams and management, the ‘baby’ reached maturity and the idea turned into a useful product.

And a concluding thought here: Be passionate about reaching your goals, remain humble, and always strive for total equality.

What is your favorite quote or personal philosophy that relates to the concept of resilience?

“Today is only one day in all the days that will ever be. But what will happen in all the other days that ever come can depend on what you do today.” (Ernest Hemingway- For Whom the Bell Tolls)

You are a person of great influence. If you could inspire a movement that would bring the most amount of good for the greatest number of people, what would that be? You never know what your idea can trigger.

I’d love to inspire Speedy Road from Bench to Bedside (SRBB). As you know from the first question, this is personal.

Can our readers follow you on social media? Of course. You can find me at https://www.linkedin.com/in/rafi-hofstein-8195b521

Everybody is invited to reach me on LinkedIn.

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