ND Founders Profile #143: This FouNder’s Blood Test Could Transform Prenatal Care, Increase Healthy Births Outcomes

Author: Melanie Lux

Brohman Fb Web


Company Founded: NX Prenatal Year Graduated: 1989
Title: Co-founder + CEO Degree: BBA, Finance
Location: Prospect, KY Residence Hall: St. Edwards Hall

The birth of a child is one of the most anticipated and joyous events parents experience. Smiles and hugs, flowers and balloons, followed by a quick trip home from the hospital to tackle late-night feedings, dirty diapers and exactly who the new addition looks like.

Seventeen years ago, when Brian Brohman’s son was born with spina bifida, the experience was very different. Many long weeks were spent in the neonatal intensive care unit (NICU) with his tiny boy punctuated by worry, fear and prayer.

“Even for someone like me with a medical background and who knew how to ask hard questions, it was a very difficult time. I was fortunate as I had the flexibility to be there in the NICU with him. Many parents didn’t have that because of their jobs and other children. Many babies in the NICU had no visitors,” Brohman says.

“It was heart breaking.”

Little did Brohman know at the time was that his tiny son, facing a lifetime of challenges, would prove to be his biggest inspiration. And eventually, leading Brohman to start a company whose blood test has the potential to transform prenatal care and enable more healthy outcomes for mother and baby.

“In those early days with my son, I thought a lot about adverse outcomes in pregnancies. Some families can handle it, many can’t. We should all want the healthiest birth outcomes,” he says.

Long before this; however, Brohman was a kid growing up in Louisville, Kentucky, with aspirations of playing college hoops. Despite being co-captain of his high school basketball team, no Division 1 team came knocking. So he fell back on his academic prowess instead and applied and was accepted at the University of Notre Dame.

“Up until that point in my life, my worldview was Louisville, so I didn’t want to go too far. Notre Dame was the best school within a drivable distance of home and the culture was a natural extension of my Catholic education,” he says.

According to Brohman, it turned out to be a great time to be at Notre Dame. In 1987, the Fighting Irish’s Tim Brown became the first wide receiver to win the Heisman Trophy. The next year, Notre Dame won the NCAA national championship in football with a 34-21 win over West Virginia. In terms of personal wins, Brohman put into practice a guiding principle of the university.

“When it comes to academics, the peer pressure at Notre Dame is intense. Pretty early on, I learned the work hard first then play hard mindset. The mantra was reinforced by everyone there,” he says.

It served him well, too. Graduating with a degree in Finance, he accepted a job in Miami with Southeast Bank. Within two years, Cordis Corporation, a global leader in cardiovascular and endovascular devices, recruited Brohman away from the bank to work in corporate finance and business development. During his first four years with Cordis, from 1991 to 1995, annual revenue grew from $100 million to $500 million, due in part to a breakthrough technology, angioplasty balloon catheters.

In 1995, Johnson & Johnson acquired Cordis for $1.8 billion, which at the time, was the company’s largest ever acquisition. Cordis and Brohman were rolled into Johnson & Johnson’s cardiovascular stents portfolio. His career entered an exciting new phase: licensing and acquisitions. “The experience was invaluable as it taught me how to assess medical technology from a 360-degree worldview. I analyzed everything from clinical and regulatory to intellectual property and costs of goods and assimilated all of that information into the final financial modeling.”

The experience, says Brohman, was “intense.” By the time he left he left Johnson & Johnson in 1998, he’d completed 36 technology evaluations and added a wealth of expertise. At this point, he decided trade health care for heavy equipment, going to work for Wayne Huizenga, the most prolific mergers and acquisitions (M&A) businessperson in South Florida. Huizenga was well known for founding Auto Nation and Waste Management and co-owning Blockbuster Video, the Florida Marlins, Miami Dolphins and Florida Panthers.

“Wayne built companies through M&A, and was ready to do that with NationsRent, which rented heavy equipment to construction and industrial customers,” Brohman explains. “It was rapid fire M&A; I was involved in 60 deals in two years, growing the business from zero to $600 million in annual revenue. I learned a lot but missed working in an industry that had a direct impact on people’s lives.”

Brohman’s heart was in medtech. He and his family moved back to Louisville where he first joined a startup called Aptamera with a cancer drug. Fairly quickly, Aptamera exited to a publicly traded British company, delivering a nice return for investors. He then moved to another drug development startup, raising $50 million on their behalf. The 2008-2009 market crash was not kind to niche biotech startups, and the company closed.

At this point, Brohman began shopping for diagnostics and imaging technology. By 2012, he and long-time collaborator, Dr. Alan Ezrin, founded NX PharmaGen to develop and commercialize two new products using an imaging platform and a molecular platform based on exosomes.

The first spin-out, NX Development Corporation, was led by Ezrin, which successfully launched in the United States a new brain tumor imaging agent, which remains in first line use today. In 2014, Brohman took the reins as CEO at NX PharmaGen’s second spin-out, NX Prenatal, to develop a series of liquid biopsy (blood) diagnostic tests that would accurately predict high-risk pregnancies.

It seems Brohman had come full circle to his desire to help families avoid problem pregnancies. “Prenatal care has not changed since the 1930s. Expectant mothers under an obstetrician’s care all go through the same cycle of 14 office visits even though 15 percent of pregnancies result in pre-term births or preeclampsia. This was a huge call to action to find a way to get out in front of those adverse events.”

Up until now, there’s been no way to identify high-risk conditions early in a pregnancy—you can’t biopsy the placenta. NX Prenatal had to devise an entirely new way to identify these conditions as early as nine weeks into a pregnancy. Brohman believed the answer could be found in exosome particles found in blood that circulate between mother and her developing baby in the womb. Identifying specific biomarkers could provide real-time insight into at-risk pregnancies and allow doctors to provide more personalized care.

Over the last nine years, NX Prenatal has worked to unlock the mysteries of exosomes in pregnancy and has succeeded in identifying specific biomarkers for blood tests to identify women at high-risk for pre-term birth, preeclampsia and placenta accreta, conditions that threaten the health and lives of mothers and babies. “What’s exciting is what we’re doing at NX Prenatal with our blood tests does not exist today in pregnancy care. It is totally new and has the potential to transform care.”

He adds, “With this knowledge, doctors can provide interventional care and informed mothers can be more proactively involved in their care. For example, moms in increased risk categories can make lifestyle changes, adhere to physician recommendations and medicine regimens, and benefit from increased surveillance, all of which may help avoid complications.”

NX Prenatal has garnered tremendous attention from leading academic medical centers, medical journals and experts in obstetrics and reproduction. It’s also attracted the interest of those who want to reverse the troubling trends among Black mothers whose rate of pregnancy-related complications and maternal death rates are three time that of white women. In February 2023, NX Prenatal Inc. announced a partnership with the Louisville-based Health Equity Innovation Hub to establish a new Alliance for Prenatal Health Equity. Funded by Humana Inc., the Humana Foundation, and the University of Louisville, the partnership seeks to advance health equity and improve health outcomes for Black women in Louisville and communities around the country. NX Prenatal’s blood tests will play an integral role in the multi-year project to reverse trends and gather data.

NX Prenatal has been funded by a combination of investor dollars and non-dilutive funding in the form of grants, blood samples and equipment from partner organizations. To date, the company has raised $20 million and is currently wrapping up a Series A round with a target of $10 million. Thus far, NX Prenatal has closed on $6 million, which will go toward the launch of the first test for pre-term birth and advancing the next two tests for preeclampsia and placenta accreta.

“We’ve raised money the good old-fashioned way: talking to people. The response from high-net-worth individuals, venture funds, and seed funds has been positive, but we’re still actively fundraising,” Brohman says.

Investors to date include lead investor Solas BioVentures, Golden Seeds, The Jump Fund, Mindshift Capital, Key Horse Ventures, Commonwealth Capital, and VisionTech Angels to name a few.

Brohman says the biggest challenge NX Prenatal has faced to date is being new and potentially redefining maternal healthcare delivery. “Being a ‘me too’ technology or product is so much easier than commercializing something that does not already exist. Up until now, there was no such thing as a first trimester blood test to determine the risk of pre-term birth or preeclampsia or any blood test to detect placenta accreta. When you think that big and your plans and goals are big, that’s a high bar for success. You have to get a lot of people, smart people, to buy in.”

That said, challenges are part of the startup game and the nearly ten years of pushing the rock up the hill have delivered a number of wins for the NX Prenatal team. Their advisory team includes experts in obstetrics and reproductive science, bioinformatics and biotech product development. They have landed important industry partners including Thermo Fisher Scientific and amassed an impressive patent portfolio and multiple scientific publications.

In the next few months, a landmark study validating NX Prenatal’s liquid biopsy platform will be published in a peer-reviewed journal. The study was led and co-authored by principal investigator, Dr. David Haas, a Notre Dame alumnus and vice chair of research for the Indiana University School of Medicine. The National Institutes of Health-backed, case-controlled study involved a cohort of 20 geographically diverse sites across the United States and 400 subjects representing all races and ethnicities. Blood samples were gathered from all subjects, tested for NX Prenatal’s biomarkers, and ultimately proved the company’s hypothesis on using exosomes to determine high-risk pregnancies.

Simply put, this will be an absolute game changer for NX Prenatal as it pushes ahead on its commercialization efforts and ultimately clinical adoption by obstetricians the world over.

As big as this study is, the best is yet to come. “The biggest win will be when the first test is launched, and we help the first patient achieve a healthy pregnancy outcome,” Brohman says.

The serial biotech entrepreneur offers this counsel to future startup founders:

“Always seek to make yourself the dumbest person in the room and surround yourself with smart people. Be intentional in creating luck. Do this by telling your story to as many people as you can, in many venues as you can, as often as you can. Focus on your team. The best teams I’ve been on wake up each day to magnify the efforts of others on the team. The magic happens when you’re all magnifying each other’s work.”

Brohman also encourages founders to take the advice of one of Louisville’s most famous sons, boxing legend Muhammad Ali:

“Impossible is just a big word thrown around by small men who find it easier to live in the world they've been given than to explore the power they have to change it. Impossible is not a fact. It's an opinion. Impossible is not a declaration. It's a dare. Impossible is potential. Impossible is temporary. Impossible is nothing.”