Benign prostatic hyperplasia (BPH) is common health issue in men in which the prostate enlarges and puts pressure on the urethra, causing urinary symptoms. Treatment options have evolved in recent years, with minimally invasive approaches gaining ground against effective but complication-prone surgical procedures. Neal Scott, MD, PhD, an interventional cardiologist, serial innovator, and the founder of new Fogarty company-in-development ProximaRX, is taking the treatment of BPH to the next level.
ProximaRx is developing a catheter-based solution that combines an expandable mesh stent, a drug coating, and compatibility with electrically-assisted techniques such as iontophoresis and electroporation that enhance drug delivery across skin and other tissues. Inspired by studies demonstrating the sustained effectiveness of drug-coated balloon dilation as a treatment for BPH, ProximaRx’s powerful trifecta aims to offer flexible treatment duration as well as utility for other indications such as urethral strictures and potentially, prostate cancer. ProximaRx is participating in Fogarty’s company accelerator program (CAP), with the goal of advancing its prototype and commencing clinical studies.
Research-driven solutions
The company’s unique approach reflects Scott’s extensive research into the feasibility and utility of local delivery of drugs to blood vessels. An accomplished physician, researcher, and innovator, Scott has 14 published patents, most of which involve the design and use of catheters to deliver novel drug therapies to specific sites in the body.
In an effort to bring his research to the bedside and help patients, Scott also founded two previous companies. Early in his career, while on the academic faculty at Emory University, he investigated ways to prevent acute clotting after coronary angioplasty. The current standard of care was to give the patient high doses of systemic anticoagulants, which often led to bleeding complications and a dangerous situation if the patient required emergency bypass surgery. Working with three other faculty members, Scott invented a catheter that could deliver anticoagulants locally with a much-reduced dose and the same efficacy.
The team decided to start a company around their technology, but changes in the environment dictated a pivot. “Research coming out of Emory at the time showed that radiation applied to the coronary artery could prevent the other major problem associated with angioplasty – restenosis, the chronic re-narrowing of the artery at the angioplasty site over the subsequent months – which frequently caused patients to require another angioplasty procedure,” Scott said. As a result, the company refocused and developed a catheter that could deliver x-ray radiation inside a blood vessel. In 2000, the company, called XRT Corp, was purchased by Medtronic.
Later, Scott and a collaborator, Josiah Wilcox PhD, dug into the problem. When their research led to the conclusion that this narrowing was caused by injury to the outer wall of the artery during the procedure, Scott launched a second company to develop a radiation catheter that targeted this area. However, when the FDA approved drug-eluting stents, a powerful new approach for combating restenosis, he pivoted again, redesigning the new catheter to deliver the drug paclitaxel. “When we combined local drug delivery with a bare metal stent, the procedure had outcomes on par with drug-coated stents at a fraction of the price,” Scott explained.
Boston Scientific was interested in Scott’s work, and entered into a joint venture with his company, MedLuminal Systems. “We met our milestones on time, and they ultimately purchased all of the company’s IP,” Scott said.
Early Inspiration
Born in Brooklyn, New York, Scott recounts a childhood in which he was often sick. This led to frequent encounters with a primary care doctor who was also a leader in his neighborhood. “I had known from the age of two that I wanted to be a doctor and a scientist, and so I decided to model myself on him,” he said.
After prep school in Brooklyn, Scott traveled to Stanford University for his undergraduate studies. He majored in chemistry, one of the toughest undergraduate pathways available, then went on to an MD-PhD Program at Harvard Medical School /MIT. The dual program had an intensive focus on science and engineering along with traditional medical training, which appealed to Scott. “I wanted to be a doctor and help patients improve their lives, but I also know that as a scientist, I could help even more people by solving problems through discovery and innovation,” he said.
To facilitate these goals, Scott completed a residency in internal medicine at UCSD, a cardiology fellowship at Stanford, a postdoctoral research fellowship at UCSD, and an interventional cardiology fellowship at Emory University Medical Center.
Today, he is the medical director for the cardiac rehabilitation program at El Camino Hospital but has otherwise retired from clinical cardiology. He now is a startup researcher and CEO. To help him along his journey, he joined Fogarty Innovation to work with Fogarty’s team of experienced medtech executives. “They all have deep backgrounds in helping small companies get started and move forward, and their advice and assistance has been invaluable,” he said.
Scott adds that the organization’s fully-equipped, 30,000 square foot facility is a much better place to work than his kitchen table. “I’m really enjoying being part of the Fogarty community, learning from the educational programs and interacting with the other entrepreneurs,” he said.