Early childhood determination to be a scientist
Born in Ahmedabad, a town in Gujarat, India, Pahini comes from a family with a strong academic record. She particularly looked up to her grandfather on her father's side who was the first in his family to be university educated. It was also highly unusual for his generation in India at that time. He went on to become a professor of mechanical engineering. What really inspired Pahini about her grandfather was his inner strength and perseverance. As she points out, 'When he was pursuing his PhD in Germany, not only was he required to learn German in order to get his PhD, he managed to finish his studies in two years as he had a family back in India'(Hall). His achievement encouraged Pahini's father to train as an engineer and her uncle to become a doctor. Having such role models, Pahini says, made it seem very natural to both her and her cousins to also go to university.
In addition to her father's family, Pahini was greatly inspired by her mother who she describes as 'one of the most persistent and resilient' people she knows. As she says, 'no barrier is big enough to stop her'. Due to chronic ill-health, which started when she was a teenager, her mother was unable to pursue her dream of becoming a medic so decided instead to become a pathologist. She managed to work for some years in a pathology laboratory until she was forced to retire due to her ill-health.
Pahini first expressed an interest in science when she was just eight years old. She vividly remembers the day when she firmly told her parents, with her hand on her hip, that she had decided to become a scientist. When they asked why she replied because 'I want to make an impact and make a difference to people's lives'. Always encouraging of her ambition, her parents pointed out the many different ways of making an impact such as being an engineer or a doctor. But Pahini continued to be adamant that she wanted to be a scientist. Importantly, she wanted to have the means to 'discover new knowledge' and develop 'cutting edge technologies' which she believed could have a much wider and more positive impact than if she became an engineer or doctor.
What also inspired Pahini's interest in science was learning at school about the groundbreaking discoveries of other scientists which had a major impact on the world. She was particularly taken with the work of Rosalind Franklin, a British chemist whose x-ray diffraction studies laid the foundation for cracking the double-helix structure of DNA which helped revolutionise investigation of disease pathways, diagnose genetic disorders and develop new drugs. A skilled experimental scientist, Franklin also helped uncover the molecular structure of RNA, viruses, coal and graphite. Another person who made an important impression on Pahini's young mind was Niels Bohr, a Danish physicist best known for his major contributions to the understanding of atomic structure and radiation emission. Involved in the Manhattan Project to build the first atomic bomb, Bohr was subsequently awarded the Atoms for Peace Award for his efforts to promote the use of atomic energy responsibly.
Very academically driven, when Pahini was at school she had many different interests, including history and languages. At one point she also developed a passion for archaeology and palaeontology, but the one area she became hooked on was biology. One of the lightbulb moments for her growing up was when she went to watch Jurassic Park, an American science fiction film that came out in 1993 which features dinosaurs genetically engineered by scientists using ancient DNA. Crucially, she says it 'made me realise there was a whole world out there which I probably didn't know about' including 'the potential of genomic sequencing.'
Desire seeded early to become an academic and combat cancer
Pahini's desire to pursue science at an early age, she says, was very much rooted in the fact that 'I've always been a very impact driven person. No matter what I do, it has to have some form of meaning'. Early on she knew that she really wanted to be an academic and was not put off by the fact that going down this avenue was highly competitive. Where she thinks she was lucky was the fact that her parents were highly supportive of her decision, who themselves 'broke their own barriers of their times.' As Pahini puts it, 'they were trailblazers in their own right. And that really helped me.'
Right from when she was at school, Pahini set her sights on becoming a scientist at the University of Cambridge. One of the reasons she wanted to do this was because Cambridge was an important hub for scientists who won Nobel Prizes. Pahini admits Cambridge was a highly ambitious goal because at that time few people in India even went to university, let alone managed to study abroad.
Shortly before Pahini left school, she tragically lost one of her close childhood friends to leukaemia, blood cancer. Just 17 years old when he passed away, his death had a profound impact on Pahini. One of the few people to be with him at the end of his life, Pahini found the experience 'extremely upsetting' as well as 'very unfair'. Growing up she had seen a number of people in her family die from cancer, but she says somehow his suffering 'hit home much harder'. Desperate to try and help her friend she did a lot of reading about the disease. On doing this reading she realised she really wanted to pursue a career in cancer research. Part of the attraction was because the disease is so complex and difficult to treat. She says it provided her with a hard challenge she knew would like to take on.
When Pahini left school in 2006, she decided to do a BSc degree in biotechnology. But only a handful of universities in India offered this course. As a result she landed up at Fergusson College in Pune, a sprawling city in the western Indian state of Maharashtra. Hundreds of miles away from her family home, going this far to university was highly unusual for a young woman in India at this time. One of the reasons she chose to go there was because Fergusson College offered one of the most comprehensive biotechnology courses in India and it also had a very good laboratory setup which would equip her with the right skills for pursuing an academic career.
Making the move was not easy because Pahini did not speak Marathi, the local language of Pune. She recalls 'It could be lonely, with everyone else chattering away and you not knowing what was going on. I struggled with everyday life, just little things like getting the right bus' (Hall). But never one to be defeated, Pahini took on the challenge of learning Marathi alongside her biotechnology degree which she completed in 2009. Having conquered this hurdle, she then turned her sights to finding a way to study in the United Kingdom. This was not easy because the country had just been hit by a recession as a result of the financial crash of 2008 which reduced the amount of funding and places for international places.
Despite the difficulties, Pahini managed to get an offer from King's College London to do a master's degree in molecular biophysics. Thrilled to get into one of her dream universities, Pahini deliberately chose to study in the same department where Rosalind Franklin had made her groundbreaking discovery. Still remembering the loss of her childhood friend, Pahini decided to focus her master's research on cancer. She investigated a biomarker for breast cancer and development of nuclear magnetic resonance spectroscopy and mass spectrometry for cancer detection.
But being a student in London at the age of 20 nevertheless was daunting. With the course lasting just a year, Pahini not only needed to quickly adjust to a totally new culture but also to a new education system with a very different method of assessment. Going out of her comfort zone she believes was one of the best things she could have done because, she argues, 'I learned so much more than I could have had I not done that.'
The doctorate challenge
For Pahini, the master's degree represented the first stepping stone towards doing a doctorate in the United Kingdom. Knowing this next step would not be easy, because funding was sparse, Pahini researched the profiles of students who had succeeded in going down this route. From this she learnt that candidates stood a greater chance of succeeding if they already had some work experience or publications. It also helped to have an established relationship with potential supervisors. Based on this Pahini decided to get an extension to her visa, which made it possible for her to get work experience in the United Kingdom.
Pahini's strategy paid off. She landed up working for two years as a research technician in a laboratory at King's College London. During that time she managed to get a publication out of her master's research, and to build up a network of people able to support her application for a PhD. In 2012 she started a PhD in the same laboratory. The advantage of remaining in the same place was she was already very familiar with the work going on there. In addition they knew what skills she had, which meant she had more autonomy to pursue her own ideas than she would have had elsewhere. It also gave her a stronger position to secure funding.
Pahini's PhD project centred on the interplay between biology, physics and chemistry, which had always interested her. A lot of her research involved investigating how the shape of cancer cells influences their spread through the body. In particular she studied how two specific proteins - Rac and Rho - regulated the shape of cancer cells. Researchers had already demonstrated that Rac forced cancer cells to elongate and become spindle-shaped and Rho to make the cells become round in shape. What Pahini wanted to know was how these proteins were switched on and off by genomic mutations and affected by physical cues in the surrounding tissue environment. She was also interested in understanding whether the cells could in turn use the proteins to alter their shapes and the environment around them. Understanding the shape of cancer cells and how this affects their migration through the body was important to the development of new treatments.
Cancer strikes even closer to home
Taking four years to complete, the PhD proved highly challenging. What sustained Pahini through days in the laboratory when nothing seemed to work, she says, was the memory of her childhood friend and desire to find a new way to treat cancer. Then two years into her research she experienced her own cancer scare, which gave her an extra sense of urgency about her work. Falling sick quite a lot over several months, Pahini was eventually referred to an oncologist for tests for blood cancer, the same disease her childhood friend died of. But she then had to wait a whole month to get the results back from the tests. Unable to tell others of her predicament, including her family. because she did not want to unnecessarily worry them, Pahini found the experience extremely harrowing and isolating. She remembers that every single day, she kept thinking 'the longer I wait the less likely I am to survive.'
In the end Pahini's illness turned out to be due to a vitamin D deficiency and not cancer. But the delay in getting the all clear really clarified for her the major challenges involved in getting a quick cancer diagnosis. One of the reasons she realised it took so long was because of the slow turn around of different wet laboratory tests required. Many of these were the same tests she was doing in the laboratory for her PhD. This got her thinking that there must be a better way.
Transitioning to become an entrepreneur
Importantly her cancer scare made Pahini question whether the academic route was really the right way forward for her to make the impact she originally set out to achieve at the age of eight. The harsh reality, she realised, was that discoveries made in academia could take between 20 and 30 years to get translated into the clinic. As she argues, 'I wasn't willing to wait that long because cancer was unwilling to wait for anyone.'
As a result Pahini's begun searching for alternative options to make a quicker impact, which she did by getting involved in a range of extracurricular activities and organisations. For example, in 2016 she took the opportunity to get immersed for a few months in an entrepreneurial programme run by Stanford University Graduate School of Business. In addition she became the president of Innovation Forum in London, an organisation set up to help equip scientists with skills to translate their research into the clinic. These activities gave her a better grasp of how she could build on her PhD work to improve the diagnosis of cancer.
In 2017 Pahini gained a position as a postdoctoral researcher at the Medical Research Council Cancer Unit at the University of Cambridge. Having finally achieved her dream to be a scientist in Cambridge, Pahini eagerly soaked up the rich entrepreneurial opportunities on offer in the city. This saw her taking on various leadership roles in organisations including Cambridge Consulting Network and the Entrepreneurial Postdocs of Cambridge set up to help facilitate the entrepreneurial and business potential of the university's research.
On spreading her wings, Pahini became particularly drawn to the energy and spirit of start-ups. She soon realised that going this route would give her the 'lifelong challenge' she had sought since a young child. It also shared many parallels with academia in that no two days are the same and gives space to always learn something new. What also appealed to Pahini was the autonomy that start-ups offered for moving a project. In many ways she saw heading up a start-up was comparable to being a principal investigator, which involves managing your own group, identifying problems to solve and sourcing funds.
While certain now that 'entrepreneurship was the best path towards my vision of helping patients', Pahini was unclear how to progress her ambition. But this became clearer once she attended the Biotech and Healthcare Venture Creation Weekend run by the Entrepreneurship Centre at Cambridge Judge Business School. She learnt about the event from The Office of Postdoctoral Affairs and the Postdocs 2 innovators network. Importantly, she says the weekend gave her a 'window into the life of an entrepreneur'. Over 72 hours she gained insights into all the stages necessary to build a team, an idea, develop a business proposition, validate it and then pitch the venture to a panel of experts. She explains, 'For me the benefits didn't just end there, I built my confidence and found a team with whom I continued to work on the venture that we pitched' (Pandya 2018).
Following the weekend, Pahini continued to work with her new-found team members to refine their idea and validate market demand. Once they had something concrete, she decided to apply to the Impulse Programme based at the Maxwell Centre, University of Cambridge, a three-month programme designed to teach entrepreneurial basics mixed with mentorship to support the development of a project (Pandya 2018). The programme provided a perfect opportunity for Pahini and a friend to push forward on the development of an intelligent health management platform to tag skin cancers. While they encountered a lot of teething problems, Pahini learnt a lot from the experience (King's Entrepreneurship Institute).
One of the highlights of the Impulse Programme for Pahini was it assigned her with a mentor who she says 'couldn't have been a better fit. He had a background in medicine and law; had worked both in the policy sector as well as life science investment. This helped us move from a rudimentary technology to a demonstrable version of a very-early product in two months. This combined with one-to-one sessions with experts took me to a pitch-ready stage.' Overall the experience meant 'I could now actually envisage raising funds and taking my product to the market!' (Pandya 2018).
The adventure and excitement of a start-up company
Eager to pursue her idea further, Pahini joined Entrepreneur First, a programme that helps pair individuals to build a company and covers living costs to test out ideas at a fast pace. This led her to found a start-up company in 2018 with Pandu Raharja-Liu, an expert in machine learning, to build an artificial intelligence (AI) based diagnostic for cancer. Pandu left the venture soon after, but by then the company had a strong team with complementary expertise in machine learning software development, bioinformatics and pathology.
Called Panakeia Technologies, the company set out to create an AI technology able to detect subtle variations in the appearance of cancer cells directly from a patient's tissue sample, called a biopsy. Its key objective was to provide accurate diagnostic results in a fraction of the time it usually takes.
A lot of Pahini's initial work for the company involved mapping out the journey a patient goes through from the time they are first suspected of having cancer all the way to when they get treated and then get discharged. As part of this process she spoke to many different stakeholders involved in the care of patients so that she could understand the particular challenges they faced along the way. This flagged up for her a specific set of challenges faced by pathologists which she realised the company might be able to solve.
The key issue lay in the time-consuming workflow necessary to process a tissue sample once taken from a patient in an operating theatre. One of the reasons it takes so long is the many different steps the sample has to go through within the pathology laboratory, which requires a lot of human labour. First the sample has to be preserved and embedded within paraffin wax before it is then very thinly sliced to be mounted on a microscope slide. It is then stained with a mixture of dyes to highlight different structures in pink and purple. This process is relatively quick, taking a maximum of a few hours. Once this is done a microscopic image is taken of the slide and then analysed on the computer by an experienced pathologist who searches for any islands of cancer cells. This can be done in a few minutes.
Describing the work of the pathologist as a bit like searching for a needle in a haystack, Pahini says this is relatively easy where there is just one image per patient. But generally the process involves combing through several images per patient to diagnose if they have cancer. If they have cancer then additional molecular tests are needed. This involves sending a further sample for laboratory testing using immunohistochemistry, polymerase chain reaction and/or next-generation sequencing. The tests are used to detect certain biomarkers, like genetic mutations and particular proteins which are helpful to determining the best treatment for the patient. But they can cost several hundred pounds and can take several days or weeks to return the results (Pandya 2022).
After speaking to many pathologists, it began to dawn on Pahini and her team that the problem could possibly be solved by finding a way to reverse engineer the work she had done for her PhD and combine this with advances in AI image analysis. They aimed to develop a method able to pick out certain molecular characteristics, or biomarkers, contained in routinely collected digital microscope images to identify what was the best course of treatment for a cancerous sample. What was appealing about this solution was the diagnosis could be made directly from routine microscope images. This not only promised to make diagnosis much faster but also more accurate because it reduced the multi-step process with lots of human intervention into a single one.. Additionally it would cut out the need for additional molecular tests. If it worked it had the potential to not only speed up the diagnosis process and reduce the bottleneck in cancer services but also free up laboratory capacity (Pandya 2022).
What the team also realised was such a method could help address the shrinking number of people working in pathology. This was a topic that repeatedly came up in Pahini's discussions with British pathologists, who pointed to the increasing numbers of pathologists retiring who would not be replaced. The shortage of pathologists was not confined to the United Kingdom, but also a major problem in less developed countries. In Zambia, for example, the Panakeia team found there were only ten pathologists working in the whole country made up of 17 million people. Similarly in India, which has a population of 1.4 million, he noted there were less than 2,200 pathologists (Pandu). By eliminating the need for multiple-lab-based tests, the company hoped to not only to make diagnostics faster but more affordable, paving the way for precision medicine to be more accessible to patients even in poorer parts of the world.
By the end of 2019 Panakeia Technologies had assembled a team to start building out its machine learning-based digital pathology platform. Soon after this COVID-19 hit, which forced them to recalibrate how they were going to get the product to market. Reflecting on this period, Pahini says that the pandemic forced them to get very creative. Rather than being a hindrance, lockdown in fact provided them with a great opportunity because it freed up usually over-stretched pathologists to collaborate and test out the company's platform. Encouragingly their feedback was highly positive and indicated they were already beginning to make more use of digital pathology and were very ready to move away from just relying on the microscope. From Pahini's perspective this marked a big shift in their mindset which the company capitalised on to build its first clinical product.
In October 2021 Panakeia Technologies gained regulatory approval for its first AI based image analysis system to be clinically used by health services in both the UK and the EU for the diagnosis of breast cancer. It is a deep-learning software tool which can be integrated into the digital cancer diagnostic workflow. The tool is designed to replace wet-lab assays rather than replicating pathologist analyses. Performed after cancer has been diagnosed by the pathologist, the software provides molecular biomarker status which informs treatment of the cancer. Able to provide a diagnostic readout within just fifteen minutes from the original microscopic image of the tissue sample, the tool can also help determine which treatment is most appropriate for the patient (Cooper; Anon). By this point the tool had been validated against 650 cases and additional studies were underway (Scialom). Since then the company has begun expanding its platform to diagnose various cancer types
.Looking back, Pahini says that one of the biggest hurdles she faced at the beginning of building the company was the need to learn quickly and move very fast (King's Entrepreneurship Institute). One of the key things she also realised early on in the journey, was that getting the product developed was not just dependent on solving scientific challenges. It also relied on having the right people in place to make it happen. Getting regulatory approval was also a big learning curve because the product was so new there was no set pathway for doing so. She stresses 'every single member in our team is an innovator in their own right, because most of the things we were doing had never been done before.' But that is what has made the journey so exciting for her.
Always be ready for 'curveballs' is key to a career in science
When asked how she would advise others looking to follow in her footsteps, Pahini emphasises the need for resilience and persistence. This is because, as she says, 'you will always come across curveballs, things don't go as planned'. For her, one of the most important things is to 'keep an open mind' and focus on how to solve a problem 'rather than getting bogged down by the problem itself.'
In her case she says 'I quickly learnt that not giving up is critical in life. Every time I failed, I analysed, improved and tried again with something better than before. What I learnt is that not only perseverance, but also the ability to improve every time you are rejected, is important. If you genuinely want something, don't take no for an answer. You'd be amazed how far persistence and your hard work can take you' (Hall). One of her guiding principles over the years has been 'keep trying and learning' (King's Entrepreneurship Institute).
For anyone at the start of their career, Pahini recommends they follow what really interests them. She also advises reaching out to people who interest them to find out the journey they have taken. By doing this, she says 'you'll learn that they are very similar to you and they face very much the same challenges as you do.' As she comments, 'Everybody faces the same challenges. We just don't talk about it.'
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This story was written by Dr Lara Marks based on her interview with Dr Pahini Pandya on 11 August 2023. It also draws extensively on the following sources which appear in brackets in the text:
Anon (21 Oct 2021) Test predicting effective treatments from routine cancer samples approved', Med-Tech Innovation News. .Back
Cambridge Network (21 Oct 2021) 'Groundbreaking AI platform transforms breast cancer diagnosis and treatment'.Back
Cooper, E (21 Oct 2021) 'Ground-breaking AI test could transform breast cancer diagnosis and treatment', JF Media.Back
Hall, S (no date) 'Pahini Pandya: Childhood loss and a personal crusade to beat cancer', Women Ahead of their Time.Back
<King's Entrepreneurship Institute (19 March 2019) 'Meet the King's 20 Founder: Pahini Pandya, Co-founder, Panakeia'.Back
Panda, P (10 Dec 2021) 'Seeing more from every sample: using AI image analysis to transform clinical decision-making', European Pharmaceutical Review.Back
Pandya, P (15 July 2022), SME of the Week: Panakeia, Digital Health London.Back
Pandya, P (2018) 'Five steps to Entrepreneurial Enlightenment', University of Cambridge, Maxwell Centre.Back
Pandu, R-L (2020) 'AI and the democratisation of cancer diagnosis with Panakeia Technologies'.Back
Scialom, M (28 Oct 2021) 'Panakeia's 15-minute breast cancer test approved for use', Cambridge Independent.Back
