“We foresee the need to upscale our facilities. That seems to match well with the ambition of SBMC”.

April 1, 2023

Martijn Cox article

Xeltis, one of our valued consortium members, developed the world’s most advanced polymer-based platform of restorative cardiovascular implants that allow patients to restore their own tissue. Xeltis’ devices naturally evolve into living blood vessels or heart valves, when colonized by patient’s own tissue, a therapeutic approach that is called Endogenous Tissue Restoration (ETR). Following the news Xeltis recently raised another € 32 million to drive the clinical development of ETR, we had a few questions for founding father and Chief Technology Officer Martijn Cox.

What are you working on at the moment, Martijn?

“We’re working on several products, but our most advanced application today is for patients that have kidney disease. They need to undergo dialysis to get their blood cleaned several times a week. And for that they need a blood vessel, a connection to allow that dialysis process to take place. We are developing a blood vessel to make that connection. At the moment dialysis grafts are our most advanced product.”

A few weeks ago, Davita Venture Group, together with Invest NL invested €32 million in Xeltis. Other parties invested quite a large sum of money before. You seem to be able to attract investors quite easily. What’s your secret?

“I don’t think there’s really a secret in the sense that many things need to be right before you can attract these amounts of money. It really starts with a technology that’s truly groundbreaking, in our case a platform that has potential in several applications. Secondly you need to have a great team. You need to have people on every single topic that are good at what they do, that have shown experience in what they do because that’s what investors look at. And the third is, we’re very happy with our existing investor base. Some investors that where there from the beginning have kept investing with every round. And we’ve had the luxury of having some very reputable life science VC’s in our cap table for several years. Investors attract investors. If you have been able to convince the first reputable VC, you need to keep doing the right things, but to attract the second one will be easier, because they also follow each other’s lead in that sense.”

Xeltis was founded about 15 years ago. That’s quite a long time. Have you ever considered to throw the towel?

“I’m not the towel throwing kind of person. But yeah, of course, in 15 years a lot of things can happen and will happen. You need to be able to rethink and to redraw the plan and to pivot. We have a platform technology so we can work on different applications in parallel. Which is not easy, but it does allow you, let’s say if you hit a roadblock or a delay or an unexpected result with one application, to have the option to prioritize another one, an alternative one, until the roadblock on the first one has been resolved.
“Today our flagship product is a blood vessel for dialysis patients. We’re still working on a heart valve for children. And we have worked on a heart valve for adults as well. But every few years a different product will be your flagship because you inevitably hit roadblocks and you have to say, okay, my flagship becomes a side ship and I make a new flagship to allow us to keep making sufficient progress. We had to make several of these strategic choices over the years.”

Has something came up in the last 15 years that makes life of a medical startup easier than when you started?

“I’m afraid not, no. What definitely is a positive note is that doing clinical trials and developing products in the US, seems to have become easier. There is a trend that the FDA is willing to accommodate innovation. But the opposite is happening in Europe where it’s increasingly difficult to move the new medical directive. So as a net result, I don’t think it’s easier now than 15 years ago.”

Despite your busy schedule, you became a member of the Program Council of SBMC. What was your motive?

“Well, one needs to invest in an ecosystem. Also it feels quite natural. A good portion of the SBMC network was already in the Xeltis network, so it felt quite natural to join and be part of SBMC. In addition, Xeltis is scaling up. We are growing. That’s also why we raised these significant amounts of money. So we will need a next step in our production processes. We will need to upscale our facilities. And this seems to match well with the ambition of SBMC to provide or help with production capacity for scale ups like Xeltis. We also joined with the idea that our timelines may match up and that we can help each other on that journey.

Last question. What will be the next milestone in Xeltis’ history?

“I mentioned we are working on dialysis grafts. In April, we plan to announce the six month results from our first clinical trial. So that’s a milestone. And we already started running a pivotal clinical trial for that same product. And once we can share those first results, that will be a very big next milestone.”

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