Launch OS for cancer centers commissioning compact microbeam radiotherapy and running first immune-combination programs.

1. An oversubscribed seed round funding the first clinical prototype means microbeam is moving out of lab-only mode and into hospital launch planning.
2. A stated end-2028 first-patient goal gives early centers a finite window to line up commissioning, governance, and first-case workflows.
3. If microbeam is meant to improve chemotherapy and immunotherapy effectiveness, radiation oncology can no longer deploy it as a stand-alone machine project.
4. Compressing a synchrotron-scale beamline into under 10 square metres shifts the bottleneck from giant infrastructure to clinical execution inside real cancer centers.
5. Additional preclinical and regulatory work makes structured QA and evidence capture immediate requirements for every early site and protocol.

Catalyst. CollimateHealth's funded clinical prototype, sub-10-square-metre footprint goal, and end-2028 first-patient target make site-readiness and first-case orchestration immediate bottlenecks.

The product gives an early-adopter center a dedicated workspace for taking microbeam from feasibility to first patient. It links commissioning tasks, dosimetry and QA checklists, protocol milestones, tumor-board eligibility decisions, and systemic-therapy scheduling in one timeline that both physics and clinical teams can use. For each candidate, it produces a structured treatment packet with site-readiness status, patient-fit criteria, beam-plan checkpoints, and immune-monitoring tasks instead of scattering that information across email and spreadsheets. For leadership, it shows launch-critical metrics such as time to commissioning, protocol bottlenecks, and case-conversion rates. Over time, the company builds a proprietary dataset on how novel radiotherapy programs move from prototype to clinical routine across centers and indications.

What's different. Generic radiotherapy planning systems handle beam calculations, CTMS vendors handle study administration, and device OEMs provide fragmented commissioning support, but none of them owns the cross-functional launch workflow for a brand-new radiation modality. This company sits in the narrow but strategic layer between machine readiness and patient treatment, where physics QA, oncology coordination, and regulator-grade evidence must converge. Defensibility comes from a multi-center dataset on launch timelines, early-case workflows, combination-protocol patterns, and operational outcomes that single-site tools and single-vendor stacks cannot easily replicate.

Jobs to be done

flowchart LR
  Buyer[Cancer center launch team] --> Pain[Disconnected commissioning and first-case workflow]
  Pain --> Product[Microbeam launch OS]
  Product --> Outcome[Faster clinical readiness and cleaner early evidence]

Executive takeaways

• The credible near-term market is not broad radiotherapy IT; it is the narrow launch layer for a small set of advanced centers commissioning novel modalities and collecting first-case evidence.
• The wedge is strategically attractive because incumbents split the workflow across treatment planning, oncology information systems, CTMS, and manual QA practices rather than owning cross-functional launch orchestration.
• Category timing is the dominant risk: compact microbeam hardware is moving toward the clinic, but clinical indication fit and operating norms are still being formed.
• The venture case improves materially only if the product expands from microbeam into FLASH, compact proton, MR-guided, and other novel-radiotherapy rollout programs once the first workflow templates are proven.

Market definition

A control-plane software layer for commissioning novel radiotherapy programs and converting early patient cases into repeatable, audit-ready operations.

Customer and buyer

Primary users are chief medical physicists and translational program managers; economic buyers are department chairs, cancer-center operators, and innovation leaders funding new modality launches.

Buying triggers

• A center decides to host or evaluate a compact microbeam system, turning modality readiness into a cross-functional launch program instead of a physics-only project. [1][2][3][4]
• A translational site opens or expands an MR-linac, proton, or registry-heavy advanced-radiotherapy program and needs repeatable implementation playbooks. [17][18][19][20]
• Leadership needs regulator-ready QA, protocol, and case-review evidence rather than ad hoc binders, spreadsheets, and siloed systems. [21][22][23]

Willingness to pay

Centers already absorb meaningful staffing and coordination burden to launch advanced modalities, so a workflow layer that compresses chart review, protocol coordination, and QA handoffs can plausibly win budget from program-launch or clinical-innovation spend even without replacing incumbent TPS or EHR systems. [19][20][21][30][31]

Category dynamics

Growth signal 16% cumulative increase in European radiotherapy treatment courses by 2025

Validation signals

• CollimateHealth has already raised seed capital to build a clinical prototype and continue regulatory/preclinical work.
• PTCOG still shows both a large operating base and a meaningful construction pipeline for particle therapy centers.
• The MR-Linac Consortium and MOMENTUM show that advanced-modality sites accept shared implementation registries and harmonized workflows.
• Centers are already building home-grown QA workflow infrastructure such as QATrack+ when vendor systems do not cover launch requirements.

Regulatory & technical constraints

• If the launch OS starts making patient-specific clinical recommendations, medical-device compliance burden rises materially under EU law.
• Cross-site patient and workflow data sharing must meet health-data privacy controls, especially when U.S. and EU centers are compared or benchmarked together.
• Early modality launches are likely to sit inside formal studies or registries, so protocol versioning, audit trails, and investigator-ready evidence capture are mandatory.
• The software must interoperate with existing TPS, OIS, and QA programs rather than forcing centers to swap out entrenched clinical systems.

Competition is fragmented rather than direct: planning and record systems own treatment workflows, CTMS and EHR tools own protocol administration, and OEM or in-house teams own the first-site launch checklist.

Why incumbents do not win by default

• Treatment planning and oncology information systems. Varian, Elekta, and RaySearch own planning and treatment records, but they do not win by default because first-program commissioning, combo-therapy timing, and cross-team evidence capture sit outside their core workflow.
• CTMS and EHR vendors. OnCore and Epic can manage protocols and records, but they are not designed to run machine-readiness, dosimetry QA, and physics sign-off dependencies.
• OEM professional services. Hardware vendors can help the first install succeed, but their services are usually single-vendor, high-touch, and weak at benchmarking or standardizing launch performance across centers.
• In-house QA and project stack. Spreadsheets, binders, and home-grown scripts are flexible for pioneers, but they do not scale well for audit trails, multi-site learning, or multidisciplinary peer review.

This company should start as a launch OS for a very small but urgent buyer set: academic cancer centers preparing compact microbeam evaluations and first immune-combination protocols. The customer pain is operational, not dosimetric: once hardware exists, sites still need one audit-ready workflow for commissioning, tumor-board eligibility review, combination-therapy scheduling, QA sign-offs, and protocol evidence capture. The first sale should be a paid launch deployment to a DACH or Swiss center with a proton or experimental radiotherapy program and a signed microbeam evaluation project, sold jointly to the chief medical physicist and the radiation-oncology chair or COO. The wedge is attractive because incumbents split the work across TPS and OIS systems, CTMS tools, OEM services, and spreadsheets, so no default vendor owns first-program orchestration. The plan deliberately avoids clinical decision support, broad radiotherapy IT, and community-hospital rollout until the company proves it can shorten launch timelines and produce cleaner first-case evidence with read-only integrations. The microbeam-only market is too small and too timing-sensitive to justify a venture case on its own, so the first 12 months must test whether the same workflow sells into MR-linac, compact proton, or FLASH-style rollout programs. Market size, pricing, and SOM are modeled from analogs rather than transaction data, and the biggest current gap is the lack of named pre-2028 launch sites and direct proof of standalone budget ownership. Investors should treat this as a pre-seed workflow wedge worth watching closely, not yet a full partner-meeting case, until design-partner commitments and adjacent-modality reuse are verified.

Problem

• Early microbeam sites still manage commissioning, case review, QA, and protocol evidence across disconnected TPS, OIS, CTMS, OEM, and spreadsheet workflows.
• That fragmentation slows first-patient readiness, creates incomplete treatment packets, and weakens the audit trail needed for study, registry, and regulatory work.

Solution

• Provide a vendor-neutral workspace that links commissioning tasks, physics QA sign-offs, protocol milestones, tumor-board eligibility review, and systemic-therapy coordination on one launch timeline.
• Generate structured first-case packets, exportable evidence binders, and readiness dashboards so sites can treat early patients with fewer manual handoffs and clearer launch metrics.

Why we win

• The company sits at the cross-functional boundary between machine readiness and patient treatment where incumbents and OEM services do not own a complete workflow.
• Every launch compounds reusable playbooks and benchmark data on timelines, QA dependencies, case conversion, and multi-vendor coordination that single-site tools cannot replicate quickly.

Milestones

flowchart LR
  Wedge[Microbeam launch wedge] --> MVP[Commissioning and case-packet MVP]
  MVP --> Proof[Faster readiness and audit-ready first cases]
  Proof --> Expansion[Adjacent modality expansion and benchmarks]

Founding team

Experiment roadmap

Risk assessment

What must be true

• At least 3 Europe or North America centers with active microbeam evaluation plans must commit to paid launch pilots before the category reaches routine patient volume.
• Buyers must fund $200K-$450K of first-year spend from launch or innovation budgets before recurring patient throughput exists.
• The product must cut launch timelines by at least 25% or keep incomplete first-case packets below 10% versus spreadsheet or OEM-service baselines.
• An adjacent modality such as MR-linac or compact proton must reuse most of the workflow without a ground-up rebuild.
• The product must remain workflow and evidence infrastructure rather than patient-specific clinical decision support.

Open diligence questions

• Which named centers already have signed compact microbeam evaluation projects and what workflow stack do they use today?
• Does budget ownership sit with the radiation-oncology chair, the innovation office, the chief physicist, or inside an OEM implementation package?
• What KPI threshold would make a site renew after the first launch year instead of reverting to OEM services and spreadsheets?
• How much of the workflow can be reused across MR-linac or compact proton commissioning without custom product work?
• What regulatory position will counsel and buyer compliance teams take if the product assists eligibility review or combination-therapy timing?

Model sanity

• Revenue engine. Base revenue comes from moving from 3 paid pilots in Y1 to 8 live launch programs by Q4Y3 while blended site revenue rises toward the researched $450K first-year spend range.
• Must go right. Adjacent-modality reuse has to begin by month 18 so the company can grow from 4 production centers in late Y2 to 8 live programs in Y3 without a ground-up rebuild.
• Model breaks if. The base case only bottoms at about $0.1M of cash, so a 12-month sales cycle or sub-68% gross margin likely forces a bridge before Q4Y3.
• Next-round proof. A seed-ready story is 4 annualized production centers, one adjacent modality template, benchmark reporting, and an 8-12 week deployment playbook by late Y2.

Scenarios

Sensitivity

flowchart LR
  TargetCenters --> PaidPilots
  PaidPilots --> LivePrograms
  LivePrograms --> LicenseRevenue
  LivePrograms --> LaunchFees
  LivePrograms --> ModuleExpansion
  LicenseRevenue --> Revenue
  LaunchFees --> Revenue
  ModuleExpansion --> Revenue
  Revenue --> GrossProfit
  GrossProfit --> Salary
  GrossProfit --> Opex
  GrossProfit --> Cash

Flags: Base case cash bottoms near $0.1M in Q3Y3, so even a 1-2 quarter sales slip likely needs a bridge or a larger seed. · The model assumes adjacent-modality reuse works by month 18; if not, the microbeam-only wedge is too narrow for the Y3 revenue path. · Eight live programs inside a roughly 30-center SAM means revenue concentration stays high and the first 2-3 references matter disproportionately. · Gross margin has to improve from 65% in Y1 to roughly 72% in Y3; slower template reuse would pressure both runway and next-round readiness.

• Category timing risk. If compact microbeam systems reach clinical sites later than the stated timeline, the beachhead market may mature more slowly than expected. Mitigation: Start with centers and OEMs already funding translational launch work, and design the workflow to support adjacent novel-radiotherapy programs before microbeam volume arrives.
• Heterogeneous clinical evidence. Immune-response and combination-therapy benefits may vary by tumor type and protocol, which can make one-size-fits-all workflow assumptions dangerous. Mitigation: Keep the product configurable around protocol design and evidence capture, and position it as an execution layer rather than a source of clinical efficacy claims.
• Incumbent stack squeeze. Treatment-planning vendors or device OEMs could bundle lightweight commissioning tools to defend the account. Mitigation: Integrate into incumbent systems while owning the cross-functional orchestration, benchmarking, and multi-center evidence layer that single-vendor tools do not provide.