Isaac Ro, CFO of Thrive

Thrive is a healthcare company whose mission is to bring earlier detection of multiple types of cancer into routine medical care using a simple blood test, known as a liquid biopsy. In October, Thrive announced that the company is expected to be acquired by Exact Sciences for $2.15B. Pulse writer Tara Sullivan connected with Thrive’s CFO Isaac Ro to talk about his career and Thrive’s pursuits.

The Pulse: Will you tell us about your career path and how you arrived at Thrive?

Isaac Ro: When I graduated from college, I was interested in business and chose to start off in consulting. I soon realized I was very curious about how the stock market works and how businesses are valued. So, I pivoted and spent the next 16 years as a Healthcare equity research analyst on Wall Street, with most of those years at Goldman Sachs. I focused on a sector known as Life Science and Diagnostic Tools. I really enjoyed that experience because these stocks are unique in that they are driven by a combination of science, Healthcare policy and their financial prospects. It’s a really complex equation and at the same time, there is a tremendous amount of innovation across the industry, particularly in the field of genomics. I joined Thrive as CFO in May 2019 right when the company launched. Fast forward to 2020, COVID has obviously been a terrible thing but one silver lining is that it has made diagnostic testing top of mind for people everywhere. COVID will take many lives this year but cancer takes many lives every year. Detecting cancer earlier with liquid biopsy is a big idea because we know survival rates are dramatically better when the disease is found in earlier stages before tumors grow and spread. We have an opportunity to make a really significant impact.

The Pulse: Several companies are trying to succeed in the liquid biopsy space. Where is Thrive focused and what milestones have you achieved since launching?

IR: There are three primary applications for liquid biopsy: screening, tumor profiling, and disease and recurrence monitoring. Thrive and a few other companies are working on screening tests for healthy people who have no signs or symptoms of cancer. This is the killer application for liquid biopsy. It’s also the hardest one to realize. Others are focused on tumor profiling: once a cancer is diagnosed, testing interprets its genetic signature and matches the patient to the optimal treatment. This is a smaller market but high value add since better matchmaking can yield better outcomes. Finally, monitoring tests keep close eyeballs on patients in remission who are at risk of recurrence. These tests need to be high resolution and can be more expensive, justifiably so.

It’s only been about 18 months since Thrive’s launch and we’ve achieved a lot. We’ve grown our team from 30 to nearly 140 and we’re proud of the diversity we have. Our scientific founders at Johns Hopkins have been working with Geisinger Health System since 2017 to study a prototype of our blood test in 10,000 people. In April, we published the results of this landmark study in the journal Science: our test identified cancers with high specificity and at earlier stages. Those results jump started this industry and put Thrive on the map.

The Pulse: We’d love to hear about your experience joining Thrive. The company was very young and small when you started; what were your first days like?

IR: My prior work on Wall Street was at Goldman Sachs which has >30,000 employees, so joining the Thrive team of less than 30 presented a different day-to-day reality. We were sharing an office in Cambridge with two other startups and we were still hanging up the Thrive logo on the wall when I started. But even on the first day, it was clear to me that we were setting forth on a big mission with a lot of ambition, talent, some great data, but not a whole lot of tangible assets. We had the whole world in front of us, with a lot of ideas that were well-conceived but still unproven.

It was also clear that I was surrounded by people who had taken jobs for Thrive’s mission. There is a huge need to change the way cancer is diagnosed, and as a result, potentially have an outsized impact human health. This is about as big an idea in healthcare as you could think of. While it was sometimes scary to think we had a lot of work to do, one of our cultural mottos is to be unwavering. We were extremely unwavering in those early months, confident that our work would have a positive impact on the world. That was empowering, to go into the unknown with a mission we thought was very pure. I am very proud and thankful to have been invited to be part of it.

The Pulse: You joined a science-heavy startup without a hard science background; how did you assess whether this was the right next career step?

IR: I’m a methodical person – I looked closely at the team and had a high degree of confidence that we could navigate the unknown and pivot well. Our lead investor is Third Rock Ventures, arguably the most successful biotech VC of the last 10-15 years. They’ve launched more than 50 companies and know how to build successful biotech organizations. Also, several folks on Thrive’s team came from Foundation Medicine; they were pioneers in genomic cancer testing and had created a lot of commercial value.

Also – Thrive’s investor syndicate had an appropriate perspective on what it was going to take to succeed. It’s one thing to raise money once, it’s another thing to know you’re going to have to come back in the future to realize your goals. Our investors had deep pockets and a long view, so I felt confident we would be able to walk the path together. This was really important.

The Pulse: As CFO, you guided Thrive through its Series B raise and recently to an exciting sale. What are the synergies between Thrive and Exact Sciences that made this the right acquisition deal?

IR: In October we announced the acquisition for $2.15B (pending close) and there are a couple big merits to this transaction. Exact Sciences is one of the most successful companies in cancer screening over the last 15-20 years. They developed a product called Cologuard which revolutionized colon cancer screening. They run over 2 million tests a year, and started at essentially zero just seven years ago. The scientific, regulatory, and commercial expertise they’ve built reflects over a billion dollars of investment. They have a massive sales force, huge operational infrastructure, real technical chops that Thrive would need to replicate for our own business. The deal gives Thrive a huge jumpstart in all of those areas.

Thrive brings tremendous expertise in liquid biopsy; there are only a handful of companies that have a team that knows how to bring this technology to life and we’re one of them. Our founders at Johns Hopkins, led by Dr. Bert Vogelstein, are the pioneers in cancer diagnostics and screening. They are focused on getting this technology into people’s hands; in fact, Bert’s self-stated dream is to bring the earlier detection of cancer, including many with no screening tests available today, to the masses. The acquisition will help us accelerate that dream.

This marriage between Thrive and Exact is highly complementary and all of the key market forces are converging now so it’s a great combination of fit and timing.

The Pulse: From your seat at Thrive, what’s your outlook for the molecular diagnostics market?

IR: I’m really optimistic about the molecular diagnostics market. The healthcare system is more focused than ever on driving efficiency up and costs down. One way to improve outcomes is to diagnose earlier and match patients to the right drugs faster – this is an area where molecular diagnostics can be valuable. This space has a lot of great opportunities for investment and a great place for people to build careers and companies.

The Pulse: What’s a broader healthcare industry trend you’re keeping tabs on?

IR: Digitization of healthcare is a mega theme I’m watching – so many areas of healthcare are ripe for automation and digitalization. We see this already with robotic surgeries and with the increasing pervasiveness of software in healthcare. We’re also seeing huge opportunities to apply artificial intelligence and machine learning to accelerate drug development. Let’s get more space age – digital therapeutics – will software-as-a-drug be a thing? Can an app help to treat ADHD? On Wall Street, we historically defined most healthcare companies in one of three baskets: drug companies, device companies, or services companies – I think those lines are rapidly being blurred by digitalization. We’re going to see hybrid business models we haven’t before seen.

The Pulse: You’ve advanced quickly throughout your career – getting promotions, expanding scope, working on exciting deals. What’s your secret sauce?

IR: It’s actually quite simple: choose your career based on the people you work with. At each major inflection point in my career, there’s been a purposeful decision to choose the people above everything else. This has had the single biggest effect on my personal success. People tend to get enamored with technology, salary, titles and business cards – all those things are important to defining success, but if you start by solving for the quality of people with whom you work and learn from, that informs more than you might want to believe.

Interviewed by Tara Sullivan, December 2020.