Medtech partnerships built on capital alone rarely go the distance. The most successful companies are often backed by investors who contribute more than money—and founders who know how to make the most of that support. That was the focus of a standout session at LSI Europe ’24, where Marta Zanchi, Founder and Managing Partner at Nina Capital, sat down with Christina Vallgren, Co-Founder and CEO of Terapet, for a candid conversation about navigating the highs, lows, and long-haul dynamics of the investor-founder relationship.

Terapet, a spin-out from CERN, was founded in 2019 to tackle a fundamental gap in cancer care: precision. Even the most advanced form of radiotherapy, proton therapy, still faces uncertainty about where protons land inside the body. That problem—and the drive to solve it—launched Vallgren and her co-founders on a journey that’s been shaped just as much by scientific rigor as it has been by startup resilience. At every stage, her partnership with Zanchi and the broader investor group has helped turn hard problems into tangible progress.

From CERN to Commercialization: Founding Terapet

Before founding Terapet, Vallgren spent over a decade at CERN as a physicist. The original idea for the company came when a colleague building Austria’s first proton therapy center realized just how hard it was to align clinical requirements with technical constraints. Even with a $200M machine, physicians still couldn’t verify where the protons were landing, forcing them to over-treat margins—and patients.

“That’s a frustration not just for doctors but for physicists,” Vallgren said. “You spend all this energy building the perfect machine, and then you realize there’s uncertainty at the most critical point.”

The desire to bridge research and real-world application led Vallgren and her co-founders to incorporate Terapet in late 2019. Just a few months later—at the height of the pandemic—they raised a seed round and formed a partnership with Nina Capital. That timing, challenging as it was, became a foundational inflection point for both the company and the investor-founder relationship that followed.

Lessons in Flexibility: Evolving the Vision

Terapet’s early focus was clear: elevate proton therapy. However, as the team engaged more with the market, they realized a broader opportunity. “Proton therapy is powerful but niche,” Vallgren noted. “To attract further funding and deliver greater value, we needed to broaden our scope.”

That realization prompted a strategic pivot. Today, Terapet is developing a standalone nuclear imaging platform with applications far beyond radiotherapy. The goal? Enable theranostics, precision diagnostics, and a more scalable impact across the healthcare landscape.

That evolution required alignment with investors—not just in theory, but in practice. “Most investors tell you to focus,” Vallgren said. “But the ones that matter are those who help you see new paths without losing sight of the core.”

Building Strong Investor-Founder Partnerships

So, what makes an investor-founder relationship actually work?

Transparent communication, according to Vallgren. And not just at board meetings. “You need to talk before the meeting. Share raw data. Align on interpretation. Use the board meeting to make decisions, not to download slides.”

That kind of prep—and radical candor—has become a best practice for Vallgren, especially when navigating board dynamics. “We hold one-on-ones with every board member before the actual meeting,” she explained. “That way, we avoid misalignment and build trust.”

Trust also shows up when times get tough. Like many medtech startups, Terapet’s early days were defined by the dual pressures of runway anxiety and product development. In those moments, Vallgren said, the best investors didn’t panic. “They showed up. They stayed engaged. They didn’t disappear when things were going well, and they didn’t point fingers when things got hard.”

Zanchi summed it up with a word that stuck: unflappable. “This journey is chaotic. The best investors are unflappable. They look at change in the face and stay focused on the mission.”

The Role of the Board: Support, Not Surveillance

One of the most overlooked dynamics in medtech is the boardroom itself. Vallgren emphasized how critical it is to choose the right independent directors, especially in Series A and beyond.

“Investor directors may be assigned, but independents are where founders often have a say,” she said. “They’re not just there to break ties. The best ones bring domain expertise, network connections, and a focus on the long-term health of the company.”

And while founders can’t always choose who sits on the board, they can—and should—push for alignment. “If you can’t choose the firm, at least choose the person,” Zanchi added. “The individual on your board can make or break the relationship.”

It’s Still About the Mission

At the end of the day, all the mechanics—communication, governance, capital strategy—only matter if they’re in service of something bigger. Vallgren’s advice for any founder starting this journey?

“Let your ego go. Find investors who challenge you. And stay aligned on the mission.”

That mission, for Terapet, is no longer just about refining proton therapy—it’s about reimagining nuclear imaging for precision medicine worldwide. As they kick off their Series B round, Vallgren and Zanchi remain focused on one shared principle: the best investor-founder partnerships are built on trust, transparency, and a relentless focus on solving real problems.

Conclusion

There’s no one-size-fits-all formula for startup success—but if this panel at LSI Europe ’24 proved anything, it’s that the investor-founder relationship is one of the most powerful levers for growth. Whether you’re adjusting product-market fit, expanding your team, or simply trying to stay alive in a down market, the right investor can help you see around corners. And for founders, staying open, honest, and engaged with those investors is just as critical.

In Vallgren’s words: “Hard times create strong startups. But strong relationships make it possible to get through those hard times in the first place.”

Want more insights like this? Join us for our next medical technology conference at the Ritz-Carlton, Millenia Singapore, from June 10th-13th.