Ten years ago, most medical research was conducted in closed systems, without shared datasets and insights to more rapidly accelerate the discovery of potential cures for diseases.
Today, Derk Arts’ startup, Castor, is serving more than 3 million enrolled patients across 90 countries, supporting 8,500 studies and helping to change the face of clinical research through advanced data science and automation.
Bootstrapping basement life
Derk Arts was completing a PhD in medical informatics (the intersection of information science, computer science and healthcare) and interning at an intensive care unit in Amsterdam, when he saw just how big the data problem is in medical research.
During his internship, he was asked to contribute to a research project that was storing individual patient data in separate Excel files, presenting a host of red flags from issues of patient privacy, to inefficiencies when merging data sets. Applying his early background as a developer, Derk volunteered to build a secure, easy-to-use web-based platform for data capture that could make research projects run more smoothly, while improving data quality at the same time. And so the first version of Castor was born.
At the time, European countries were beginning to create new rules for how they collect and process personal data (which later evolved into GDPR), accelerating the urgency and availability of funds to solve the patient privacy problem. But Derk recognized the need for a solution to problems far broader than data privacy.
He saw that medical data, one of the world’s most valuable assets, was being wasted in modern-day research. Castor’s platform not only enables researchers to run all aspects of clinical trials in a compliant cloud environment, it also helps researchers standardize their data using machine learning. In turn, Castor is working to create a future where researchers can co-create and access the most extensive, diverse and distributed medical research dataset the world has ever seen, to allow the medical community to discover potential cures for diseases much faster.
Encouraged by market headwinds and a steady flow of customers, Derk bootstrapped Castor for five years throughout his entire PhD and just beyond that, working three jobs and taking no salary for the first three years.
That meant that Derk could put Castor’s revenue towards their first key hire, Sebastiaan Knijnenburg, who joined in 2013 and acted as CEO for an extended period of time, coding with Derk in the afternoons and owning the platform while Derk ran growth efforts (today Sebastian is Castor’s Principal Innovation Engineer). In 2015, Rob Konterman joined Castor from The Boston Consulting Group (BCG) as Chief Operating Officer, to support finance, legal, processes and scaling. And finally, in 2016, Derk made the leap to full-time CEO.
Commercial growth meets increased impact
In 2017, Castor secured a €1.1M Horizon 2020 grant from the European Commission, and in 2018, Castor went on to raise a $6.25M Seed round, enabling Castor to accelerate its growth. Castor hired amazing talent, set up its HQ in Amsterdam, and also launched its sales operations in the US–a key strategic decision that Derk jumped into with both feet, to capture a market with “a much higher density of potential customers, and with a mindset more open to adapting to change.”
Reflecting on that period, Derk says, “Moving offices gave me this confrontational take on our growth, in a positive way. We went from a freezing basement, to an office with a friend with two desks, to a space with five desks shared with a DJ who would sometimes be practicing music there, to somewhere that finally resembled an office and becoming too big for that, and at last, our main HQ in Amsterdam. As a founder, putting a lot of thought and love into a space, and seeing people create something meaningful there, was extremely rewarding.”
Alongside its expanded footprint, Castor went on to gain traction among more than 50,000 users across academia and commercial research, powering more than 4,000 studies. Then, in the midst of Castor’s global expansion, COVID-19 hit.
Castor quickly made its platform freely available for all non-profit COVID-19 research starting in February 2020, and to date, is one of the only providers that can enable large-scale decentralized trials to accelerate the work of researchers who are trying to combat the disease.
More than 200 COVID-19 projects across 33 countries are currently running on the platform, including the World Health Organization’s global Solidarity trial. Through Castor, more than 10,000,000 COVID-19 data points have been captured and 50 COVID-19 projects have committed to making their data reusable and accessible to others. One of the projects helped estimate, in near real-time, what ICU occupancy would be in the coming days–and Derk made calls to Alteryx and Tableau to get them to donate their technology, which allowed the dashboards to be streamed live to hospitals across the country.
Derk shares how important the pandemic was for making progress on decentralized clinical trials. “Technology can make trials more patient-centric, more efficient, and can ultimately help reduce the need for patients in clinical trials–and that’s where you start to get more transformative. Being able to recruit more patients globally means we can enroll a more diverse group of patients in trials. So we increase diversity in trials; we reduce the bias towards the white North American male in trials; we enroll faster (which is a direct cost reduction), and we increase patient retention through better technology because patients are happier in that trial. All these things ultimately add up to a higher quality trial that completes faster.”
Now that we are more or less back to normal, Derk says that Castor is continuing to grow their collaboration with the WHO, and hopes that this can result in a platform for pandemic readiness. “I want Castor to be ready as soon as the next outbreak happens–able to capture data from patients wherever they are, even if in the middle of the jungle. That’s where I’d like to be coming out of the pandemic.”
Collapsing the distance from data point to impact on patients’ lives
To support Castor’s positive momentum and impact, Two Sigma Ventures led their $12M Series A in 2020, with Villi Iltchev as lead Partner. And on the heels of its $45M Series B in 2021 (bringing its total funding to $65M) and in the wake of COVID-19’s reimagining of clinical trials, Derk is more confident than ever that Castor can continue to transform the industry at a global scale.
Derk credits Castor’s continued growth to its focus on accessibility. And this meaning is two-fold when it comes to Castor’s future ambitions.
First, Derk says it’s about leveling the playing field in terms of where in the world medical progress is made. Gaining access to clinical trial software systems is often a costly and steep learning and implementation curve, meaning many important research projects never get off the ground. This is compounded by the fact that all diseases and budgets are not distributed equally. According to Derk, 50% of research budgets is dedicated to 5% of disease burden.
Castor is launching a social impact committee, focused on lending its self-service platform to groups in need and providing training to researchers on the ground all over the world. This can empower researchers to design their own trials independently, capture data in a professional way, and make their findings easily accessible for other researchers to help find cures to the problems that humanity suffers from.
For Derk, accessibility is also about making research more directly beneficial to patients. “Ultimately, getting a cure to a patient relies on much more than running a trial. If we can make the data from each trial machine-readable, we can take data from thousands of trials from all over the globe, increasing diversity further and enabling researchers to draw conclusions from a much bigger dataset from a wide variety of trials, all on the same topic.”
“And with more datasets, we can train our prediction models more effectively. So one day, when you arrive at your check-up, your physician might be able to plug your data into his system and make relevant, individualized treatment recommendations for you, based on an understanding of your symptoms against thousands of other people with similar characteristics to you. But we’re quite far from that world right now. The technology is able to do it: we have prediction models already, we have large datasets, we know how to make data machine-readable, but the work is in getting it to go mainstream.”
“Castor is trying to push that envelope by making every clinical trial on our platform representable as a machine-readable endpoint that can be integrated into a process like that. There’s academic interest in using this technology to help cure rare diseases which have so little data, but we also see the big pharma companies turning this capability into a competitive advantage, streaming data in real-time into their drug discovery platforms.”
But the work is only getting started.