Maia Oncology picks up $4.25M to build out virtual primary care clinic for cancer patients

Five years ago, Liya Shuster-Bier entered cancer as an otherwise healthy 29-year-old. "I was running half marathons, eating my kale, not thinking that cancer was on the horizon for me," she said during an interview.

"I was six months out of business school when I landed in the emergency room after a flight with chest pain that turned out to be a tumor the size of an orange and within a few days I was diagnosed with a rare form of non-Hodgkin lymphoma," she said.

During her therapy, Shuster-Bier's family history of heart disease wasn’t taken into account as she started chemotherapy, landing her in multiple ER visits and hospitalizations.

Now a five-year cancer survivor,  Shuster-Bier has to manage health conditions caused by her treatment including a heart and thyroid condition and medically-induced menopause. She also is now at high risk for skin and breast cancer. 

This personal experience motivated  Shuster-Bier to launch Maia Oncology as a virtual comprehensive oncology-primary care clinic for cancer patients and survivors. The startup aims to better coordinate care between oncology teams and primary care providers.

"We are stitching together oncology and primary care,"  Shuster-Bier, Maia Oncology's CEO, said. " With Maia, our team will be working side-by-side with the oncologist team to make sure that the patients' pre-existing comorbidities and family history of high risk of comorbidities will be taken into account during the treatment."

profile photo of Liya Shuster-Bier
Maia founder Liya Shuster-Bier (Maia Oncology)

The startup raised $4.25 million in seed funding to hire more clinicians and launch its first pilot in partnership with a cancer center and health insurance company.

Maia Oncology's seed funding round was co-led and co-incubated by Takeda Digital Ventures and Yosemite, an oncology-focused venture firm launched by Reed Jobs. Other investors include BrightEdge - American Cancer Society, BBG Ventures and Coalition Operators.

Cancer treatments have improved significantly in the past 50 years and cancer survival rates have gone up. The U.S. cancer death rate has declined 33% since 1991, thanks largely to cancer research that has led to new treatments, gains in early cancer detection and, most significantly, a sharp decline in tobacco use, according to an American Cancer Society (ACS) report. 

Five-year survival rates have also been increasing for an even longer period of time. The overall cancer survival rate was 49% in the mid-1970s. It currently sits at 68%, according to the ACS.

"The survival is quite good because the treatment has gotten precise, effective and successful. At the same time, it has created a complex patient population.

U.S. patients have about a 40% chance of being diagnosed with cancer at some point in their lives.

But, patients don't stop having conditions like diabetes and hypertension once they are diagnosed with cancer but, historically, treating the cancer becomes the top priority.

Nearly 70% of cancer patients have at least one co-occurring chronic medical condition. Prevalence of comorbidities in combination with direct cardio-toxic effects of certain cancer therapies may put cancer patients at increased risk for poor non-cancer outcomes that could benefit from attention by a primary care provider, according to researchers in a study published in the Journal of the American Board of Family Medicine.

As Shuster-Bier learned personally, cancer survivors have to navigate the toxicities and long-term complications that emerge from the treatment it took to save their lives. 

Among cancer patients who survive five-plus years from diagnosis, cardiovascular disease, rather than cancer, is the leading cause of death.

There is a need to redesign cancer care to meet the changing landscape as patients survive longer but have to manage a cascade of new symptoms and toxicities that impact their long-term health, Shuster-Bier said.

"What Maia is doing is we are treating the pre-existing comorbidities that patients are coming into cancer with as well as the comorbidities that are being precipitated by the treatment itself," Shuster-Bier said. "We're doing that right alongside your oncology team. Our clinic is anchored by an onco-PCP and we're partnering with cancer centers. We're working hand-in-hand with your medical team, your surgical team and your radiation team to make sure that comorbidity management is front and center to your care."

Maia Oncology is starting with the breast cancer patient population as it is the largest cancer patient population.

"From a toxicity and comorbidity management perspective, breast cancer patients have a higher chance of dying from cardiovascular disease five years out than they do from the cancer itself. They also have massive endocrine co-morbidities with treatment because a lot of the treatment entails hormone-related drugs. These patients have to manage things like medically-induced menopause. Our goal is to scale this multidisciplinary care in the community where 80% of cancer patients are receiving treatment in this country," she said.

Shuster-Bier also believes Maia Oncology's services are needed with the growing pipeline of cancer drugs and related side effects.

"Fifty years ago, we only had 20 drugs out there and the oncologist and the nurses that were supporting the team knew all of the side effects and the toxicities that came with these drugs. Today, there are 900 drugs, there are 1,300 drugs in the pipeline, and they've gotten more toxic, they've gotten more cardiotoxic and they've gotten more endocrine toxic," she said.

She added, "Our goal with Maia is to step in at diagnosis work alongside your treatment for at least the first two years of your survivorship. We are focused on being the first business that's building that longitudinal data set about what is happening with these patients."

Maia Oncology treats patients with a virtual-first approach, leveraging telehealth and remote patient monitoring technologies with a care team of specialty medicine doctors. The startup aims to drive better outcomes by managing pre-existing conditions and proactively screening for emerging ones.

"In terms of the outcomes, we're focused on making sure patients' pre-existing conditions are well managed and we're looking to decrease the chance that new comorbidities precipitate as a result of your treatment. That means working in tandem with a patient's oncologist to talk about dosing, to talk about drug selection and treatment selection. Ultimately, we're looking to prevent the adverse events that can happen," she said.

This approach could also help to drive down the total cost of care, she noted.

"We will be working to build a dataset with patients that works in tandem with the cycles of their treatment; the cycles of their chemotherapy as well as radiation sessions, surgical sessions and surgical interventions to continuously monitor how the treatment that the patient is receiving is impacting their pre-existing comorbidity management as well as the risk of precipitating new comorbidities. And we will have the opportunity to share that in real-time with the patient's oncology team," she said.

Maia Oncology's practice will be anchored by primary care physicians supported by a team of advanced practice providers. The company also will employ specialists including onco-cardiologists, onco-endocrinologists, onco-psychiatrists and onco-nutritionists. 

Prior to launching Maia, Shuster-Bier founded Alula, an oncology symptom management company anchored by McKesson Med-Surgical. Maia acquired Alula earlier this year.

"We also piloted a concept called Alula On Call to test what it would look like to pair the marketplace with a virtual nursing team. And in doing that, we uncovered a lot of the insights that are the foundation for what we're building at Maia. So, it's a perfect acquisition for the business," she said. "We anticipate that Alula's technology and other assets will accelerate both the patient experience for Maia as well as the opportunity for us to meet our outcome goals for our patients."

In five years, Shuster-Bier envisions Maia Oncology being the leading onco-PCP clinic in the country.

"Primary care has been divorced for oncology for reasons that made sense 50 years ago but doesn't make sense in 2023,' she said. "We want to lead the industry in redesigning care, everything from shifting what type of multidisciplinary care team surrounds a patient during active treatment as well as long term and, importantly, building a viable business model alongside our anchor payers in a value-based contract that drives at matters the most for these patients. That means keeping them out of expensive avoidable ER visits, keeping them out of expensive avoidable hospitalizations, decreasing their total time on treatment, and ultimately driving down their total cost of cancer care as well as their total cost of total healthcare."