Interview with Antoine Leroy
President and founder of Koelis

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I arrived in Grenoble in 2000 and have never left. The quality of life, the cost of living, the prospects and then the scientific, technical, sporting and business emulation make this valley very attractive. Grenoble has an active job market. We are attentive to the need for balance between private and professional life, and I think I can say that we have a certain attractiveness in the Grenoble area


Can you explain the business and the special features of the medical device developed by KOELIS?

We are pioneers in the targeted, personalized treatment of prostate cancer. Our technological innovations are radically changing the diagnosis and treatment of this pathology. They are based on applied research conducted historically with the TIMC laboratory at Grenoble Alpes University, with which we hold patents, and with the Pitié-Salpêtrière University Hospitals in Paris and Grenoble.
We have developed a platform called KOELIS Trinity. With this tool, clinicians can visualize the prostate in real time, create a 3D map and record any lesions identified. This enables diagnostic needles to be guided with great precision during biopsy, and reduces the number of samples taken. Without this tool, the biopsy is “randomized” and the number of samples taken is much higher.
When the cancer is localized and of intermediate grade, KOELIS technology enables focal treatment (a new concept), which consists in planning and guiding a treatment needle to the center of the lesion to perform in situ ablation. This high level of precision enables the cancer to be treated while protecting sensitive areas such as sphincters or nerves. The patient’s quality of life is preserved, and that’s what our innovation is all about.


Is your technology unique in the world?

Yes, our product is unique, it’s a new standard in the world. It’s changing the way prostate cancer is managed, by significantly improving both the doctor’s practice and the patient’s quality of life. We have developed applications, software, artificial intelligence algorithms and robotics. This vision and navigation tool makes it possible to personalize treatment. So we’re ahead of the market and the competition. What we are developing is highly differentiated in terms of precision and ease of use.
Our technological breakthrough compared with ultrasound scanners currently on the market is based on two major innovations:
– 3D ultrasound, which enables the prostate to be viewed from all angles, unlike traditional ultrasound, which shows only a slice or section of the prostate.
– unique software that automatically merges 3D MRI images with 3D ultrasound images. This technical process enables MRI targets to be superimposed on 3D ultrasound prostates in real time during the operation, ensuring precise needle guidance despite the mobility of the prostate.


What was your development strategy?

Our strategy for accessing the market has been to target academic circles first and foremost. In our field, the engineer-physician research pairing is essential, and this is how we end up with a project that works and is accepted by the market. The very first Trinity platform was installed at the Pitié-Salpêtrière hospital in Paris. I worked in tandem with a urology resident who is now a professor of urology at the hospital. At the same time, we collaborated with Grenoble Alpes University Hospital on research into the navigation of brachytherapy treatment of the prostate. We soon turned our academic research collaborations to the international arena.
As a result, we gained the trust of a large number of renowned hospitals around the world. In the United States, Trinity platforms have been installed at Stanford, Johns Hopkins, Brigham and Women’s, Cleveland Clinic and other hospitals. New York’s renowned Memorial Sloan Kettering Cancer Center has bought a dozen from us. Thanks to this outreach, we’re making a name for ourselves and growing every year. We then turned our attention to other market segments: private urologists and regional hospitals. Today, KOELIS products dedicated to biopsies are sold in Germany, England, Italy, Spain and even Japan, countries which send out a strong signal about the quality and effectiveness of our product.


Has your company experienced fairly steady or, on the contrary, meteoric growth? Are you a start-up or a scale-up?

KOELIS is a company of 100 people based in France, Germany, the USA, Asia and Latin America, which continues to structure itself to absorb the growing volume of business. We’re experiencing steady growth of over 30% a year. I’d say we’re somewhere between the start-up and scale-up phases. We invest heavily in research. Around 15% of our sales are devoted to R&D. The margins generated by our products are immediately ploughed back into innovation and business development.
Our market is opening up at the same pace as the development of our technology, which meets real needs. For over 10 years now, we have been interacting with urologists all over the world, constantly adapting to market needs. This is a lengthy process, as our development not only keeps pace with clinical studies and the doctors who use our device to advance their science and their national and international recommendations, but also with the constraints of medical regulations, which have become much stricter in recent years.


What have been the major milestones since the company was founded in 2006?

We have gone through 3 development phases.
From 2006 to 2012, KOELIS was in a research and development phase, working closely with our first users and customers. During this period, we filed our first patents, obtained technological proofs and the first certifications in Europe.
The second period (2012-2019) began with the arrival of our investor Medevice, which enabled us to develop a new generation of products and expand internationally. Medevice is an investment fund specializing in the healthcare sector, with a focus on “early stage” startups – the intermediate stage between business start-up and the growth phase. Their support, and that of Bpifrance, has played an important role in the technical and commercial development of our Trinity platform (now in its fourth generation) in Europe, the United States and Japan. Over and above the financing, we have forged a solid partnership with Medevice, which has also supported us in the strategic aspects of structuring the company.
From 2019, we entered a growth phase thanks to a second round of financing from InnovaHealth Partners, an American investment fund specializing in medical technology. This round of financing enabled us to expand into the United States, which is currently our biggest market.
We have set up a subsidiary and recruited around twenty people. Today, 90% of our sales come from exports.
In medical technology, the American market is strategic because it is unique and gigantic. When you obtain FDA certification, you can sell freely in every state. In Europe, it’s different. There is a single certification, the CE mark, but each country has its own administrative regulations for reimbursements, budget allocation, and national recommendations are not necessarily the same everywhere. In Europe, we prefer to work with distributors, except in Germany, where we set up a subsidiary two years ago.


Do you manufacture your Trinity product in-house?

Partially, because software is our initial core business, but here in Inovallée, we test and assemble all the electronic parts and components that make up the Trinity platform. On the other hand, we outsource the primary manufacture of these components. Three-quarters of our subcontractors are French or European. We are fortunate to have a very good network of subcontractors in the Rhône Alpes region, whose geographical proximity has enabled us to build solid relationships over the years. When modifications are required, we reopen the project to discuss with subcontractors at all levels, from design to development, from regulations to marketing.
In addition to our core business, we maintain and renew the 500 machines we sell worldwide, as well as the technological advances resulting from our R&D investments.


Are you currently involved in any research projects with Grenoble Alpes?

Yes, we’re currently at the heart of a 6-year, €10 million PSPC (Projet de recherche structurant pour la compétitivité) partnership project funded through Bpifrance.
KOELIS is the industrial leader of this project, and our role is to identify market needs, build the roadmap and find partners.
This project contributes to the development of science and job creation (PhD students, engineers). We obviously get our own engineers to work on the transfer to the company at the end of the project.
Involved are two academic research laboratories in Grenoble (TIMC) and Brest (LATIM), the Grenoble Alpes University Hospital, APHP, the Toulouse University Cancer Institute and a manufacturer (Vermon). The project aims to improve image resolution on the one hand, and integrate artificial intelligence on the other, in order to automate the targeting of prostate lesions. This fine-tuned approach to cancer detection will make it possible to promote targeted outpatient treatments to the detriment of total treatments, which are more costly and associated with side effects.

Why did you choose the Grenoble region? How does the area meet your needs? 

I arrived in 2000 and have never left. The quality of life, the cost of living, the prospects and then this scientific, technical, sporting and business emulation make this valley very attractive.
Grenoble has an active job market. It’s true that the local engineering schools enable us to recruit talented engineers. But our engineers are not all from Grenoble: we also recruit experienced profiles from other sectors. We are attentive to the need for balance between private and professional life, and I think it’s fair to say that we have a certain attractiveness in the Grenoble area.
More generally, emulation and interaction are strong in the Grenoble area, whether for research projects as I explained earlier, or thanks to Medicalps. This healthcare cluster makes a major contribution to this dynamic: companies know each other, and regularly exchange information on technological, regulatory, legal and financial developments… which is essential in today’s fast-moving world.