Seattle entrepreneur Kingsley Ndoh is driven by the memory of his aunt, who died too young of colon cancer.
A lot of things went wrong when she was sick more than ten years ago in Nigeria, said Ndoh. The clinical guidelines at the time set age thresholds for screening based largely on data from white populations, which have lower relative risk of the disease. She was also misdiagnosed and finally learned she had late-stage disease at age 50, then the recommended age at first screening. She passed away three years later.
Since then, Nigeria-born Ndoh has been on a mission to improve cancer care. In 2021 he founded health tech startup Hurone AI to support cancer treatment in Africa and beyond with remote patient monitoring and tele-oncology designed for resource-poor settings.
Ndoh not only saw deficiencies in his aunt’s care, but also sees them in digital tools developed for oncology in the U.S., which often operate with limited data on underrepresented populations and ethnic minorities. Hurone AI aims to help close those gaps, and ultimately bring its data and technology back to the U.S.
“The vision of the company is very personal to me,” said Ndoh, who trained as a physician and is a clinical assistant professor at the University of Washington.
There is about one oncologist for every 294 patients in the U.S., whereas Sub-Saharan Africa has about one for every 3,000 cancer patients, according to studies from the World Health Organization and others. People in the region also experience disproportionately high rates of death from cancer.
Hurone AI’s platform, Gukiza, augments the oncologist. Gukiza means healing in Kinyarwanda, one of the official languages of Rwanda, where the platform is being tested.
With Gukiza, patients receive individualized text messages on their phone asking about side effects and other aspects of care. Patients provide ranked answers with a simple clicks.
Clinicians can see the status of their patients on a dashboard and customize pre-crafted messages.
The platform saves oncologists time and patients the inconvenience and expense of in-person visits, said Ndoh. “We’ve streamlined the communications between patients and the oncology care team,” he said. The system also works on patients’ text-based cell phones.
“The way we build technology here in the U.S. is we just assume that everyone has smartphones. But when you go to this remote resource limited settings, you have to think more creatively,” said Ndoh.
Hurone chose Rwanda for testing because of the government’s openness to new technologies and the country’s high need, with barely more than ten oncologists for 13 million people.
Hurone aims to sell its product to health systems and biopharma companies to support testing of cancer treatments. The platform is in the final stages of approval in Rwanda, said Ndoh, and the company has plans to launch a program this year in Brazil.
Ndoh has been coordinating his team 80 hours per week across multiple time zones since bootstrapping the company and raising $150,000 from family and friends. Last year Hurone AI was selected for the Health Equity Initiative at Amazon Web Services, which has provided close to $100,000 of cloud services along with technical support. Ndoh calls the partnership “transformational.”
Ndoh brought on a technical partner Lior Romanowsky, chief of product at Hurone and co-founder of three software startups. The tech team is rounded out with cloud expert and Microsoft veteran Raymond Ononiwu, who serves as an advisor.
Other advisors are Adam Yala, assistant professor of computational health at University of California, Berkeley; Irene Dankwa-Mullan, chief health equity officer of Merative, formerly IBM Watson Health; Nasim Eftekhari, executive director of applied AI and data science at City of Hope; Isaac Adewole, former Nigerian minister of health; Doyin Oluwole, who has led multiple global health initiatives; and health tech consultant Susan Morgensztern.
The company’s name is a play on Huron, the name for ferret in Spanish. The animal is used in medical research and its brown, black and white colors represent the company’s focus on data diversity; collecting patient data and using it to improve the app is a major aim.
Hurone AI is beginning to incorporate custom-made artificial intelligence tools into Gukiza to help predict which patients will have the worst side effects and are most likely to drop out of treatment, and to tailor treatments to ensure patient engagement.
Ndoh also envisions building an oncology platform tailored to African Americans or other under-represented groups in the U.S. with data and algorithms specifically suited to those populations.
Only a small fraction of clinical trial participants for approved oncology drugs were of African descent or Hispanic, noted Ndoh. At the same time, some drugs may have distinct side effect profiles in these populations, he said. In response, the U.S. Food and Drug Administration has urged biopharma companies to collect more data on diverse patient populations.
Gukiza is a unique tool to fulfill that aim, said Ndoh. It can be used by industry to support clinical trials, testing of drugs in diverse populations and post-market surveillance, he said.
“Other systems aren’t culturally sensitive and only function optimally in advanced healthcare systems,” said Ndoh. He adds that Hurone AI customizes its app to different healthcare systems.
“When we think about responsive AI for ethnic minorities in the U.S., we think about going to the source and bringing all that data back, because it’s going to be very effective for populations here as well,” said Ndoh.
The company’s finance and operations head is Fred Hutchinson Cancer Center alum Marijiana Ruiz and its Rwandan operations receive implementation support from Christain Ntizimira, founding executive director of the African Center for Research on End-of-Life Care, a clinical trial partner along with the Rwandan Biomedical Center.
The startup’s clinical trial is run through the Rwanda Cancer Center with support from the Ministry of Health, Rwanda. Other Hurone AI partners include Breast Cancer Initiative East Africa, Rwanda Girls Initiative and Global Health Catalyst at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins.