#291 Naveen Jain: How AI Predicts Cancer, Diabetes & Chronic Illness

0:00One of the interesting thing about chronic diseases is they don't happen overnight. You don't say hey Craig you know what I was hanging out with a bunch of guys last night drinking I think I might have caught diabetes you don't catch diabetes you don't catch these diseases they develop over a long period of time it takes 8 10 15 years for you to develop a disease that means we should be able to understand when you're moving towards a disease imagine a world where illness is optional and then you open it up inside that there are three things there's a prepaid envelope you give us a Spit of your saliva, touch of your stool, four drops of finger prick blood, send it to us.

0:40We analyze 100 million biomarkers. Build the future of multi-agent software with Agency. That's A-G-N-T-C-Y. Now an open source Linux Foundation project, Agency is building the Internet of Agents, a collaborative layer where AI agents can discover, connect, and work across any framework. All the pieces engineers need to deploy multi-agent systems now belong to everyone who builds on agency, including robust identity and access management that ensures every agent is authenticated and trusted before interacting. Agency also provides open, standardized tools for agent discovery, seamless protocols for agent-to-agent communication, and modular components for scalable workflows.

1:39Collaborate with developers from Cisco, Dell Technologies, Google Cloud, Oracle, Red Hat, and more than 75 other supporting companies to build next-generation AI infrastructure together. Agency is dropping code, specs and services, no strings attached. Visit agency.org to contribute. That's A-G-N-T-C-Y dot O-R-G. So first of all, I'm Naveen Jain. I'm founder and CEO of IOM. My background has nothing to do with science. I am not the science person. I'm not a computer science person. I'm not a doctor. However, I'm as, you know, I would say a startup junkie. This is my seventh, this is my seventh company.

2:33And having done, and I think I'm a whole lot older than probably you, Craig. No, no, no, no, impossible. I'm almost 70. I turned 70. So am I. Oh, that's a great age. So I am actually turning 66 in September. Oh, well, I'm ahead of you. I turned 70 in October. Okay. But my biological age actually is now 33. Oh, really? Yes. That's impressive. I don't know what mine is. I will send you a test and you'll find out. Okay. Interestingly is that, so basically I generally, when I start companies and I'll tell you my framework. So as we get going, I'll tell you the frameworks I used to start companies and why I started Viome.

3:19So you wanted my background. My background primarily is industrial engineering. and I have an MBA in human relations. Okay, that's interesting. Yes. And so how did you start Viome? What was the inspiration and how did you pull together the... And where are you based? We are based in Seattle, Washington. So I started Viome eight years ago. And Craig, this is, you know, every adversity is always an opportunity, as one says. So here I was working on Moon Express. We became the first company to get permission to leave Earth orbit. Don't ask me what permission you need and who grants that permission.

4:11We got the law changed by President Obama, where we actually got, it's called Space Resource Act, which is anything we bring back from mining the moon, we get to own it rather than become a property of the country. So here our goal was to actually mine the moon for helium-3 for fusion reactors. And don't ask me why would you want to go and mine the thing and when are the fusion reactors coming? We'll talk about that some other day. And then we became one of the six companies to get$2.6 billion NASA contract. So you would think that I am here on top of the moon. And then my dad was diagnosed with stage four pancreatic cancer.

4:51And here I am thinking that I didn't even know he was sick, let alone stage four cancer. He was given three months to live. And unfortunately, that's all he got. It's got me thinking that, you know, why is it that we know so much more about everything, even in outer space? And we know so little about the human body. and what if we actually can find out what is changing in the human biology at the onset and during the progression of these chronic diseases. So it's not that he died from pancreatic cancer. As he was getting old, I had just taken it for granted. Of course, he's gaining weight. He's getting old.

5:38Of course, he's got diabetes. That's what people get when they get old. Of course, he's got a high blood pressure. He got to take his blood pressure medicine. Of course, he's got a heart disease. He's got to take his tetan, right? I just take it for granted. That's how life is. That's how it should be. And then I started to think about it that, you know, we as homo sapiens haven't really changed in the last 50, 100 years. Yet, yet more and more and younger and younger age, people are getting sicker and sicker. What is going on in this body? And we said, look, this is the time where we should be able to crack this problem.

6:13and anytime I start a company, I ask myself three questions. Why this? Why now? Why me? And then I'll apply that to how I started, why onto that. But I want to just give you a framework so everyone who's listening to it want to start any project, any company, at least I can give them some wisdom of having done this now for 30 years and seven companies, how you do that. So why this is really simple. You ask yourself, God forbid, I'm actually successful in solving the problem that I set out to solve, would it help a billion people live a better life? And it's not because I'm not philanthropic. Far from it.

6:52I'm a very capitalistic person, but I do know if I can build any product, any service that can help a billion people live better lives, I can create a$100 billion company. That's right. But I never wake up in the morning and say, what should I do to create a$100 billion company? So I know very clearly making money is simply a byproduct of doing things that improve people's lives. And if you stay focused every day and say, what can I do to improve people's lives? You will have a great company at the end of the day. And this is really everyone who's listening to it. I will tell you a basic trick.

7:29I know for the last 30 years, I have no alarm clock. I wake up at 4 a.m. every single day. And when I wake up, I jump out of the bed. So here is a challenge for you. When you wake up in the morning and if you're not jumping out of the bed, whatever you're doing, you should quit that day because that's not your calling. When you find something that you really, really love doing, there's no way you'll be lying in bed and not getting up and jumping out of the bed, wanting to do the things you want to do. Right. And Craig, I guarantee you, you're one of those people that jump out of the bed thinking, oh my God, what an amazing day.

8:03Yeah, it's true. So that's the first thing you do. The second thing is, why now? And here you look at this stuff and say, what had changed in the last two to three years? But more importantly, what do you expect to change in the next three to five years that will allow you to solve this problem at scale in three to five years. And this problem could not have been solved five years ago. And the reason you do that, Craig, is very simple is you don't want to be using the technology to solve tomorrow's problem that is five years old, because by the time you're ready to scale, somebody will come along and build a new stuff and you get disrupted even before you get a chance to scale.

8:47So you want to intercept the set of technologies that are coming up so you can actually scale the problem. And to do that, you take the massive problem and you break it down into what are the pieces that need to be solved. And I'll come back and explain that to you in a sense how to do that. So, you know, and so for example, if you want to live on Venus, you don't say, well, I don't know, that's not going to happen. You simply say, okay, what problems have to be solved to live on Venus? Well, you have to lead the Earth orbit. Got it. You have to go from Earth orbit to Venus orbit got it you have to land on Venus got it now you have to create a habitat on Venus got it four problems to be solved let's go one at a time and figure out what has already been solved what we know about the second stage and what do we need to change there that allows you to start to think about these problems in a modular way and then you know exactly which problems are solved which problems are solvable and what are the unknowns and you say okay let we tackle that and say can we solve that because then we know the problem gets solved right and that's really the way of looking at the things the last part of this thing this is the probably the most important part which is why me and why me comes down to is what questions are you asking that are different from what everyone else in the industry is asking because the questions you ask are the problems you solve.

10:13So for example, if you say, I want to solve world hunger. And every expert will tell you, if you're going to have 50 billion people on planet Earth, you have to grow the food more economically. You can increase the yield of the crop. There's so much food that's wasted during the transportation, you got to reduce the wastage. You have to grow the food very close to where people live. But no one will ever ask the questions, why do we eat food? Because when you ask the question, why do we eat food? You say, oh, you need energy. You need nutrition. What are the different ways can you get energy? And she said, well, plants get energy from photosynthesis.

10:55There are bacteria that are growing up in radioactive nuclear waste. They have figured out how to protect their DNA against radiation and use radiation as a source of energy. What if you can take a genetic material from these bacteria? in vivo do a CRISPR and then suddenly your radiation resistant and say honey do you want to go get some radiation instead of getting some pizza right but point I'm making is it's not that suddenly by asking a slightly different question you opened up the problem to the solution that you would have never ever thought about and that's the beauty of asking a different question so now I'm going to answer your question why did I start Wyoming and how did we go apply these principles So first thing we said was, what if we can actually understand what is happening in the human body before you develop a chronic disease?

11:46And the reason we chose chronic disease is because I believe that despite the pandemic that we saw, infectious disease is something since the invention of antibiotics and antiviral things. We've got mostly control. And yes, we're going to have every 100 years or so, we're going to have some pandemic. but this is not a problem that is facing humanity. 97 % of all of our healthcare dollars are spent on diabetes, obesity, the heart disease, the cancer, the Alzheimer's, the Parkinson's, all of these chronic diseases. And the beauty of these chronic diseases, if I may call that word, beauty, is at least one of the interesting things about chronic diseases is they don't happen overnight.

12:29You don't say, hey, Craig, you know what? I was hanging out with a bunch of guys last night drinking. I think I might have caught diabetes, right? You don't catch diabetes. You don't catch these diseases. They develop over a long period of time. It takes 8, 10, 15 years for you to develop a disease. That means we should be able to understand when you're moving towards a disease. So my first question was, if we can solve this problem, would it help a billion people live a better life? the answer is all 8 billion of us. If we can solve this problem, check that billion people. You got it. Great. Next question.

13:07Why now? And we say, look, to solve this problem, the three things must happen. You have to be able to digitize the human body. You have to be able to process massive amount of data that comes out of digitization. And then you have to be able to use AI to make sense of what is going on. Well, cost of sequencing is coming down. And even then we started about eight years ago, we saw the cost were coming down for a whole human genome sequencing to be$1 ,000. And we said, look, you know, in three to five years, it's going to plummet down to$100 because the costs are plummeting. And today we sit here and we can do a complete sequencing, unbiased sequencing, give or take$5,$6.

13:50dollars. Now, cost of processing, when we started the company, it was$47. And we said, look, God, that's high. But you know what? Cost of processors are getting faster and faster. Cost of storage is getting cheaper and cheaper. In three to five years, that cost will be down to$10. Today, we pay$1.25 for it, right? Everyone knew the AI was going to be there and AI is here, right? So we say the time to start the company is now. And we were right. The last part was the most important part, Fred. As not being a scientist or a doctor, the biggest advantage you have is you get to ask really dumb questions.

14:29So everyone in the industry was absolutely convinced the way to solve the human diseases is to know, personalize for you, and what's the most personalized thing? Your DNA, right? Every crime show tells you that every person has a unique DNA. I need to know your DNA. And my first reaction was, interesting, does your DNA change when you develop a chronic disease? So you do my DNA test and I gain 200 pounds. Has my DNA changed? No. Now I become diabetic. The DNA hasn't changed. Now I have a heart disease. My DNA hasn't changed. And by the way, and then I die. 100 years after I die, you look at my DNA.

15:10It's still the same DNA. We still look at the DNA of mummies, right? If DNA can't even tell you you're dead or alive, how will it ever tell you you're healthier or sicker? So that my first thing was, wait a sec, this is not how we solve. And I went back to Khan Academy. So what is it that happens to the DNA? Well, DNA gets transcribed to RNA and RNA is what actually determines what is going to happen in your body. And if you're not very smart, what do you say? What the fuck? Let's just measure RNA. But nobody ever told me. In this principle, by the way, you never focus on how you're going to do something.

15:50See, in my framework, you focus on what needs to be done and you never worry about how. And most entrepreneurs fail because they actually are expert in their field. And if they believe they don't know how to solve it, they say, eh, this can't be done. When you are some naive like me, we say, sure, RNA, sure we'll figure out how to do the RNA testing. That was number one. The second part was, I had to go, you know, I'm an information junkie. So when I want to start a company, I would probably read not one book, not two books, not five books. I read dozens of books on the subject. And then I go start reading science papers.

16:34So I am now reading thousands of science papers. And I'm reading that every chronic disease from Parkinson's to Alzheimer's to cancer to diabetes to metabolic diseases, all connected to your microbiome. And I have no idea what this microbiome thing is. People are talking about the gut microbiome causing that. By the way, today the new research comes out that how oral microbiome is linked to Alzheimer and dementia. It's like, okay. so here i'm reading all these things and i'm thinking wow it's really interesting that how gut microbiome is interesting well it turns out 99 or 99.7 of the genes in our body don't come from the mom and dad they come from these microbes that live in our gut on our mouth all over us 100 trillion microbes now i'm thinking if everyone now believes this is the big problem and there are tens of companies doing microbiome testing, then why is this problem not solved?

17:34So I went back to my first principle. What questions are these companies asking? And it turns out every company, until Wyoming started, even now, to date, every company, when you do a microbiome test, they do the same DNA test of microbiome. They will tell you what organisms are in a crack's gut, what organisms are in the bean's gut. and not knowing what organisms mean I'm thinking organisms mean tiny tiny human beings trust me don't ask me why I thought they're tiny human beings inside my gut and what if they are like human beings you take the same person put them in a good environment good behavior put them in the bad environment bad behavior so what we need to focus on is not who they are we should focus on what they are doing are they doing good things are they doing bad things what are they expressing and how it's going to interact with our immune system.

18:28And that is the core of the problem we need to solve. So great, simple. We're going to go do the RNA testing of the human body. We're going to do all the gene expression RNA of all the microbes in our body. And then we're going to put the AI together to do that. It's starting to feel I got the problem right. So then, so that's basically, we decided that's what the volume is going to be. All I had to do was figure out how to do this now. So I went around the country. I thought this is the easiest problem to solve. I go to Stanford, MIT, bunch of these labs. They've got to figure it out. I licensed the tech and I'm good.

19:06Turns out no one has done it. So I am now going to Los Alamos, sorry, Lawrence Berkeley, Lawrence Livermore. I was at NASA Kennedy Spears Center, NASA Houston. I'm looking through all the labs, Stanford, MIT, Duke, nothing. I was at Los Alamos National Lab now. They were working on biodefense projects. You know what Los Alamos National Lab is famous for, right, Greg? Nuclear bomb. Yeah, certainly. What could they be working on next? Biological stuff. So they're working on a biological defense project. And remember, now what is the problem they have to solve? If there is a biological terror in our great country, how would we ever protect our citizens?

19:50We couldn't care less what was in the biological realm. What we care about is what is it it's producing, how it interacts with the human body so we can create anti-growth for it, right? So they solved the same problem for a different use. So we licensed that technology from Los Alamos National Lab, exclusive license to start wild. Now, fast forward eight years. Eight years later, we have now analyzed, Craig, one million samples, one million samples, collected over 100 quadrillion biological data point when you do a test on Viome. And I don't want this to be infomercial for Viome. I just want you to know because this is something so interesting, someone who knew nothing about it.

20:40You get a kit that looks just like this, Viome Full Body Intelligence. our mission is imagine a world where illness is optional and then you open it up inside that there are three things there's a prepaid envelope you give us a spit of your saliva, patch of your stool four drops of finger prick blood send it to us we analyze 100 million biomarkers and then Then we tell you everything what's happening in your body. Your biological age, your cognitive health, your heart health, your immune health, your gut health, your oral health. And then Craig says, nah, that's for some people who are new. Tell me some nerdy stuff.

21:31Great. Here's your LPS production. Here's your uranatoxin production. Here's your leptics production. We give you everything you want to know. But then we say, look, crack, don't eat avocado right now because your uric acid production is too high. And you already, uric acid is very high in avocado. You can end up getting a gout. Don't eat avocado. And by the way, despite Popeye telling you spinach is good for everyone, you should not eat spinach because your oxalates are not being degraded. You're going to get a kidney stone. Or don't eat broccoli right now because your sulfide production is very high.

22:07You're going to end up getting a lot of inflammation. But if you want to eat red meat, eat as much as you want because choline incarnate in your red meat, your microbes are not converting them into TMA, which is trimethylamine, which gets absorbed in your blood and your liver uses enzyme called FMO3 that converts TMA into TMAO, trimethylamine oxide, that causes the heart disease. Fortunately for you, your oral microbe, P-gingivalis is not highly active. and by the way, don't take vitamin B3 because that increases the production of FMO3 but you can eat red meat safely. So we can tell you every food you should eat it and here's why.

22:48Don't eat it, here's why. And then you say, well, you know what, but I'm telling you I have constipation. What are you going to do about that? We say, oh, interestingly, there could be five reasons you have constipation. Let me tell you exactly why you have a constipation. It could be high production of methane gas that slows down the motility. It could be the high production of low production of sulfide that's actually causing you to actually have this inflammation that causing constipation. It could be low GABA, right? It could be, here are the five reasons you could have. In your case, it is the methane gas that is causing the problem.

23:30in that case please don't eat artichoke because that has high inulin is going to actually increase the methane gas production and by the way make sure you're taking alpha leupic acid you're taking these nutrients and then we walk you through everything your body needs for everything we found take 18 milligram of lycopene every day take 79 milligram amylase because your proteins are not being fermented properly. Take 22 milligram of bourbon sulfate. Take 80 milligram of elderberry. And we walk you through every vitamin, mineral, herbs, digestive enzyme, amino acid, food extract. And guess what?

24:10We custom make it just for you every month. There is no pre-made stuff. We custom make it just for you. So this stuff is mine. And it says expires on. It doesn't say manufactured on Sorry, it says manufactured on Not expired on, my bad It was made for me two weeks ago Every month I get the new one made Then we make the personalized biotics for your gut We make the personalized oral lozenges for your oral microbiome And we make the personalized toothpaste for your morning And for your evening Just for your oral microbiome Now you say, all that is good. So how do I know it's going to work for me?

24:58So we did blinded placebo-controlled studies where we show people in 90 days, not some in one year, people who had IBS, 15 % of the population suffer from IBS. 64 % of people who had constipation became healthy compared to 10 % on placebo. People who are pre-diabetic, their A1C came down by 0.42%. fasting insulin down by 25%, depression, PHQ-9 is scored down by 50%, anxiety, GAD is scored by down 47%, right? Just using food as a medicine. Now, from all the data that we collect, Craig, we are now able to diagnose stage one oral cancer, stage one throat cancer. And we launched that product today, 95 % specificity, 90 % sensitivity.

25:52and if I were to ask you you know how you detect oral cancer today correct your dentist rubs the finger on your gum and says I don't feel your cancer that's your cancer detection honestly God in the 21st century when we can land on Mars we are detecting the cancer by feeling the cancer right so now we have a saliva test that can molecularly tell you if you have a biomarker for stage one cancer. We now have same test IBD, stage one IBD that's Crohn or colitis. We are validating it for colon polyps right now, which is seven years before you develop a colon cancer. And to bring you back home in next four months, we're gonna launch a stage one pancreatic cancer.

26:43For the first time in the human history, we'll be able to do a pancreatic cancer stage one test, 95 % specificity, 84 % sensitivity. Yeah. Okay, let's look at some of these. As I've mentioned, I had Molecular You on the podcast. They track blood biomarkers. And on the subject of pancreatic cancer, and we all at this point probably know somebody who's died of pancreatic cancer, And the problem is, as you said, with your father is he can't, it's asymptomatic until stage four. They had a case of a woman that they had been tracking for some time. And while they have no specificity, they could see that something was going awry with her biomarkers.

27:41She went in for a full-body CT scan. They found lesion on her pancreas. It turned out she was stage one, and she was operated on and is healthy today. What specifically are you looking at in the case of pancreatic cancer? Is it the gut biome? That's one question. And then I wanted to talk to you about the role of senescent cells that accumulate as UH. Very nice. So first of all, remember, we are unlike most companies. We just don't look on one sample. So most companies would do just blood or they would do just stool. So we do your saliva. That means we're looking at all the oral microbial activity and all the human gene expression in your saliva.

28:32Same thing in stool. we're looking at all the gut microbial activity and all the epithelial cells that are shedding in the blood we're looking at you all this stuff same thing mitochondria all your inflammatory marker all of the human gene expression right so in this in the case of pancreatic cancer we found the three proteases that actually are the indicative of the pancreatic cancer and the polyamine production in your oral microbiome so if you were to in fact just google you can see the paper or the polyamine production in your mouth is indicative of pancreatic cancer. So we look at all of these biomarkers together to actually detect.

29:13In fact, in the case of oral cancer and throat cancer for stage one, we found 150 different things, and some of them were human gene expression, and some of them were the microbial gene expression that were indicative of stage one cancer. And so the oral markers, that's your cells, is that right? So both your cells and the microbial cells. I see. Yeah. And what, can you talk about what it is that you're seeing in those two panels, I guess, of saliva and microbiome? Yeah. So basically, again, there's a paper I can send you that all the list of the things we do, there are about 150 of them. Many of them are basically the inflammatory markers in our immune system that actually go up when we have a early stage of cancer.

30:18So there are a lot of inflammatory markers. Some of them are hallmarks of cancer that we have known about the thing. It's the expression of the gene that starts to change. So unlike your DNA, and the reason many of the cancer companies, like, you know, let's look at Grail. So Grail is an unbelievably great step what they did for a pan-cancer test. But if you look at Grail, what they're looking for is cell-free DNA, right? Problem with the cell-free DNA is your tumor has to be big enough to shed enough DNA for you to be able to detect it. So they're really, really good at a stage three and stage four, right?