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Lux Capital's Deena Shakir with Trial Library founder and CEO Dr. Hala Borno and co-founder and Chief Product Officer Steve Buck.

Despite outsized cancer mortality rates among Black patients, communities of color are dramatically underrepresented in oncology clinical trials. Clinical trials lack comprehensive representation of all racial and ethnic minority populations, and this is particularly notable for patients with cancer, where personalized oncology treatments have progressed significantly in recent decades.

Without studying how cancer treatments equally work in all patients, optimal and personalized care cannot be effectively delivered — and scientific innovation is stifled.

Trial Library, co-founded by leading UCSF oncologist Dr. Hala Borno and veteran healthtech entrepreneur Steve Buck, is advancing oncology clinical trials by enabling diversity and inclusion to realize the powerful potential of cancer precision medicine.

Today, we are thrilled to announce our investment in Trial Library, where Lux led a $5 million seed round along with participation from NEXT VENTŪRES (Julian Eison), Unseen Capital, and notable angel investors.

Enrolling fully representative samples in clinical trials has been an unsolved challenge for a generation of medical researchers. Policymakers attempted to improve diversity in research with the NIH Revitalization Act of 1993 by adding guidelines to increase representation. However, research conducted 20 years after the mandate found that the proportion of minority adults enrolled in oncology trials was still not representative of the U.S. population with cancer. In addition, the percentage of cancer trials with a primary focus on racial/ethnic minority populations was extremely low (<2%), and women have also been historically underrepresented in studies, potentially leading to poorer health outcomes down the road.

These inequities are still looming over research today. Beyond oncology, COVID-19 vaccine producers faced difficulty enrolling a diverse set of participants for their trials, even though racial/ethnic minorities were disproportionately affected by the pandemic. The FDA spotlighted this problem in April 2022 by releasing draft guidance for improving the enrollment of underrepresented racial and ethnic minorities in clinical trials.

Why does this gap persist? There are structural and individual challenges with joining a clinical trial today. Racial and ethnic minorities have lower rates of health insurance in the U.S., meaning that they often don’t receive the comprehensive care they need or the right information to enroll in a relevant clinical trial. Furthermore, there can be significant costs of both time and money to participate in a trial, from arranging regular transportation to a far-off research center to covering child care in a parent’s absence.

It’s an untenable situation — and it’s time to fix this gap.

Trial Library uses a social determinants of health framework alongside integration with care navigation to address these barriers. Dr. Borno generated an evidence-base to inform this strategy and led a randomized controlled trial that showed this comprehensive approach serves all patients, not just those from diverse socioeconomic backgrounds. Further, it accelerated recruitment more generally, especially among late-phase clinical trials.

I’ve had the pleasure of knowing Dr. Borno for nearly a decade, and she has been a go-to diligence call for nearly every company I’ve evaluated in the space. Her passion for equity in cancer precision medicine and experience as a practitioner drove her to build her own platform to combat the lack of diversity in clinical trials. After seeing it take off internally at UCSF, she decided to spin Trial Library out into a standalone company while recruiting veteran healthtech entrepreneur Steve Buck as her co-founder. Steve’s background, most recently as a VP at Ro/GM of Ro Pharmacy, co-founder of GoodRx (after acquisition of his prior company, RxDividends), and founder of cancersurvivalrates.com, paired with Dr. Borno’s deep clinical experience, make for a dream team to take this challenge on.

Trial Library is building the tech platform that patients, providers and researchers can trust to achieve greater health equity. Through Trial Library, community oncology practices are offered sponsored opportunities to identify clinical trial candidates from within their practices. This approach enables providers to broaden their offerings of clinical trial opportunities coupled with critical care navigation for their patients.Trial Library’s virtual care navigation platform then directs patients to resources for travel, logistics, food, or other services to support their participation. Providing these solutions prevents financial burdens from affecting equal research participation.

Despite being in existence for only a few months and operating in stealth mode until today, Trial Library and the team have already seen rapid traction and interest from partners.

Increasing diversity within clinical trials is a key factor in addressing disparities in healthcare and ensuring that all people benefit from innovations made in cancer treatment. We are proud to lead this $5 million seed round, building on an intersection of theses around the impact of technology on the decentralization of clinical trials and tech-enabled care delivery to advance population health. We’re looking forward to the outsized impact Trial Library will have in creating a more equitable and personalized future — one that we can all share together.

Crypto and incentive design with MIT Cryptoeconomics Lab’s Christian Catalini