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Tempus Uses AI and Big Data for Precision Medicine

When you’ve been writing about technology for as long as we have at Nanalyze you start to see patterns emerge. One of the most interesting – and potentially biggest game-changers in the life sciences arena – is the emergence of precision medicine. The approach takes into account individual variability in genes, among other factors, to predict what treatment might be most effective across a range of diseases. Advances in areas such as next-generation sequencing (NGS) mean we can understand things like cancer tumors at the molecular level, leading to specific therapies that target gene-mutated cells while sparing the healthy ones, for example. Precision medicine, at its core, is really about better diagnostics. A startup called Tempus is creating its own whirlwind in the world of precision medicine by using big data and artificial intelligence to match the disease with the cure.

An AI Healthcare Startup

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Chicago-based Tempus was founded in 2015 by the guy who made being a cheapskate on date night look cool by starting Groupon (GRPN). The AI healthcare startup has whipped up $630 million in total funding, adding another $100 million most recently in March. It was the third mega-round of at least $100 million in as many years, which means the company is growing like crazy and burning through money like they did with bras in the ’60s. The latest round vaulted the company’s valuation up to $5 billion from $3.1 billion just last year. That new infusion of cash was also enough to earn Tempus seventh place as one of the 10 most valuable AI companies in the world

Update 12/10/2020: Tempus has raised $200 million in new funding at a post-money valuation of $8.1 billion to continue growing and expanding. This brings the company’s total funding to $1.1 billion to date.   

The investor list is a bit unique, with three investment management firms topping the roster – T. Rowe Price (TROW), Baillie Gifford, and Franklin Templeton (BEN). While Franklin Templeton has been a tepid investor in private companies, both T. Rowe Price and Baillie Gifford play often in the startup market. We’ve seen the former pop up recently as an investor in biotech like synbio startup Ginkgo Bioworks and Guardant Health, a liquid biopsy company that went public in 2018. The latter is a Scottish firm with an impressive track record backing companies from Amazon (AMZN) to Palantir (PLTR). 

Tempus scientists.
Tempus has grown to 1,600 employees in five years. Credit: Tempus

Tempus also has the confidence of the Novo Nordisk Foundation, an international organization based in Denmark that supports healthcare and medical research. At about $60 billion, the foundation also boasts the largest endowment of any charitable organization on the planet. Dr. Scott Gottlieb, former Food and Drug Administration (FDA) commissioner, sits on the company’s board. Tempus has grown to 1,600 employees in just five years, with laboratories in Chicago and Atlanta.

Precision Oncology

The obvious question: What is Tempus doing with all of that funding? Probably not buying Groupons. The original inspiration for the company, according to founder Eric Lefkofsky, was when his wife got breast cancer. He was shocked by how little data doctors used to plot and plan her treatment. A new AI healthcare startup was born, and we briefly profiled Tempus last year in our article “7 AI Cancer Diagnostics Startups Digitizing Healthcare.” Cancer is a top target of precision medicine. For example, we covered ArcherDX and its precision oncology platform, which genetically sequences tumors, just days before it merged with genetic-testing company Invitae (NVTA). The North American market alone for precision medicine is potentially huge:

Market forecast for precision medicine.
Credit: ResearchAndMarkets, 2018

Tempus also attacks cancer at the molecular level by genomic sequencing of tumors but leans on AI to organize and analyze diverse datasets, from oncology notes and pathology reports to radiology and pathology images. The result, the company contends, is a data-driven treatment customized for each patient. 

In May, Tempus added two new oncology tests to its portfolio – Tempus|HRD and Tempus|TO. The former is a supplementary test to the xT, the company’s flagship broad-panel genomic sequencing test that measures 648 genes, along with the full transcriptome. Tempus|HRD provides insight into a patient’s ability to repair cellular damage and whether he or she will respond to certain kinds of treatment. The Tempus|TO is an RNA-based sequencing test that leverages the company’s vast RNA database to identify a tumor’s tissue of origin after other methods have failed.

COVID-19 and Precision Medicine

While Tempus continues to grow its AI-driven cancer diagnostic capabilities, the company is rapidly expanding its platform to other areas of precision medicine, including infectious disease, starting with COVID-19. GenomeWeb did a great breakdown of Tempus’ pivot into developing diagnostic tests for SARS-CoV-2, so we’ll just give you a few highlights here:

  • Its own version of a polymerase chain reaction (PCR) COVID-19 test that received emergency use authorization from the FDA. PCR is currently the gold standard. Tempus has the capacity to run 15,000 tests per day with a turnaround time of 24 to 48 hours. CVS Health is a major partner, with the test retailing for $100. 
  • Tempus is also developing a sequencing-based respiratory pathogen panel, which only requires a single sample to run tests for a wide range of viruses and bacteria. Such tests can return results in just hours versus days for other types of respiratory tests.
  • Tempus is all about the data, so the company is also structuring and aggregating real-world clinical and genomic data from up to 50,000 COVID-positive patients, including RNA-seq transcriptome data from up to 10,000 patients. The idea is to better understand the disease and how it affects individuals differently.

Lefkofsky told GenomeWeb that his company hopes to leverage all that data to build predictors of disease severity and therapy effectiveness, saying the ultimate goal is to arm “the physician and the patient with data as to what therapeutics are most likely to work and how best to personalize therapy.”

Other AI Healthcare Applications

Tempus is also working on applying its AI platform across a range of other healthcare initiatives, from cardiology to mental health. Regarding the latter application, Tempus can help predict what drugs a patient may best respond to based on a simple saliva swab – an area of research known as pharmacogenomics. Results are based on sequencing 20,000 genes. The Tempus|nP test is intended for patients diagnosed with major depressive disorder, general anxiety disorder, or related psychiatric conditions.

All of that delicious clinical data from patients are especially useful for helping AI algorithms match subjects to the best clinical trials. Last year, Tempus launched the TIME Trial Program, which uses clinical and molecular data to first screen cancer patients against qualifying criteria. AI then goes to work to match patients to applicable trials. The company claims it can get a patient into a clinical trial in about two weeks:

Timeline for clinical trial matching.
Credit: Tempus

Tempus has built a network for its TIME Trial Program with hospitals and academic medical centers that includes more than 50 research sites and 2,500 oncologists. The company is also peddling its vast clinical and genomics databases to support drug discovery efforts in oncology.

Acquisitions and Investments

If you’re wondering how a Chicago startup ended up with a secondary lab in Georgia, look no further than AKESOgen, the first and only acquisition by Tempus so far. The 10-year-old Atlanta biotech firm operates a commercial laboratory that focuses on genomics and clinical trial precision medicine services. In the December 2019 announcement, Tempus said the acquisition expands its capabilities into “disease areas outside of cancer and provides strategic capabilities beyond its own lab in Chicago.” Those capabilities include the pharmacogenomics services we referenced earlier, along with microbiome profiling and other diagnostics.

On the investment side, Tempus made a couple of bets on another Chicago-based biotech, Exicure (XCUR). Founded in 2009, the Northwestern University spinout had raised about $94 million, including from deep-pocketed investors like Bill Gates, but now publicly trades on the Nasdaq. Exicure is a drug development company pursuing a range of therapies around its spherical nucleic acid nanotechnology. It’s complicated stuff – we’re MBAs, not PhDs – but the basic idea is to create a nucleic acid-based nanomedicine that can slip into a cell without causing an immune response. The technology is particularly suited for skin cells, FierceBiotech reported, which is why Exicure has focused its initial efforts on treating dermatological diseases. Last year, the company announced a $25 million deal with pharmaceutical company Allergan on a couple of programs to treat hair loss

Crunchbase also lists Tempus as an investor in 8Trip, a China-based online travel platform. It’s either a mistake or… yeah, no idea.

Conclusion

Tempus is one of those companies moving so fast that in a couple of years we could probably write a whole new story about what it’s been doing to advance precision medicine using clinical data, genomics, and artificial intelligence. While it’s great to see diversification in such a young company, there’s also the risk of over-promising results across too many verticals. We’re encouraged that the well-heeled startup is still sticking with its core competency, cancer, by releasing new diagnostic tests and building out its TIME Trial Program.

The pivot into COVID-19 is tougher to call, because so many companies are making the same move, including synbio startup Ginkgo Bioworks, among others. The pharmacogenomics work, on the other hand, is particularly intriguing, given the dramatic rise in mental health issues over the last few years. No word on the company’s long-term goals of remaining private versus joining the public market, but we’ll continue to track its progress. 

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