Brian Smiga: Hi, this is Brian Smiga with my friend Ben Freeberg of Oncology Ventures on the Driving Alpha podcast. Alpha Partners partners with early-stage funds like Oncology Ventures to monetize their growth rounds when they lack capital, and we share the profit with them. Ben, welcome.
Ben Freeberg: Awesome. Thanks for having me.
Brian Smiga: Sure thing. You and I have an unusual story. When my partner and I were starting Alpha, it was just the two of us. Like any startup entrepreneurs, we were doing everything. We were looking for one key hire, and it came down to a candidate from my alma mater and a candidate from his alma mater.
Almost out of courtesy, he really wanted to give the candidate from my alma mater a lot of sway. But then I met you and I said, “Steve, we’ve got to hire this guy Ben. No question.” That was one of the best decisions I made. It was an easy one, and you get all the credit—but I did make that decision. You were a key part of building Alpha Partners into what it is today.
Ben Freeberg: Thank you very much. Thanks for that.
Brian Smiga: I know the whole backstory here, but our audience doesn’t. What’s always interesting about a vertical specialist VC fund like Oncology Ventures is that there’s an origin story. There was a pinch point, there was a pain point, where you decided to do this brave thing as a solo GP and start Oncology Ventures. What was that pain point in your life?
Ben Freeberg: The personal side of it was that while I was working with you all at Alpha, I was diagnosed with cancer. I was diagnosed at stage three A instead of stage one when I was originally brought to the hospital after a dinner with you and Steve and Chris from Pritzker. I remember going into the hospital after what felt like a regular dinner, and they told me I was fine.
That was clearly the start of a diagnosis process that was incredibly frustrating. This was some of the best medical care in the world at Mount Sinai, and they dismissed me as not having something serious enough to warrant more testing or discovery.
Then I threw a blood clot in my lung, where I really couldn’t breathe. I took myself to the emergency room, and they found a big tumor in the middle of my chest and said, “Oh, that’s probably cancer.” That was my diagnosis.
There were so many different parts of my journey—from blood clots, to being neutropenic, meaning you don’t have enough white blood cells to fight infection, through to surgery complications. All of those issues made my journey more expensive and more difficult.
I was so fortunate in so many ways to have good care, good insurance, and a good support system. And that was the first time where I thought, “If this is as good as it gets, this is broken.” Maybe new drugs can help, but there’s a huge opportunity for everything else in that journey to be improved.
Brian Smiga: Great. So everything in digital health or health services that does not have to do with the actual creation of drugs and life sciences—that’s your domain at Oncology Ventures as a first-check VC?
Ben Freeberg: That is exactly right. Our goal is to invest in companies that are commercial stage, meaning we don’t take regulatory risk. So that’s not a drug that might get approved after billions of dollars go into it.
We love and support those companies and researchers trying to find cures for very difficult disease states within cancer. But we’re focused on the infrastructure systems layer—the pick-and-shovel type of care—where we’re selling the picks and shovels to the researchers to go out and find the next drug.
Brian Smiga: What’s really interesting to me at Alpha, having worked with a thousand emerging managers, vertical VCs, and first-check writers, is that they’re my heroes. They bring the best of entrepreneurship with the savvy of having earned the right to raise a fund.
You’re in that population, and you were oversubscribed in Fund I. Along the way, there had to be a surprise or epiphany. Tell us about one.
Ben Freeberg: When we went out to raise Fund I, I took a very traditional path—reaching out to funds of funds, endowments, and institutions that traditionally have emerging manager capital. We were shut down by almost every single one within the first four to eight weeks.
I took a step back and asked myself, “Is this story right? Is this market right?” And I really believed it was. Cancer care is the most expensive disease state, growing at three times the speed of others. It has the opportunity to become a chronic disease. It’s not one disease—it’s thousands of different types.
At the intersection of where technology, drugs, and financial incentives are going, it checked every box for building an index around the space.
So I asked, “Who would care about this?” We started reaching out to cancer centers. Then we learned about community oncology centers—the places where most people in the U.S. actually get treated. One-doctor practices, five- to ten-oncologist practices in people’s backyards.
These groups became helpful customers, sources of deal flow, and ultimately limited partners. The biggest surprise was realizing we should go directly to the people closest to the problem. Once industry insiders backed us with checks, it completely changed our fundraising and go-to-market strategy.
Brian Smiga: That’s amazing. There are two superpowers driving your fund’s performance. One is that you’ve positioned yourself as the first digital-health oncology-care VC, so everything in that strike zone comes to you.
Ben Freeberg: We actually just analyzed this. We stack-ranked the top 50 opportunities in our CRM, and each of them came in from at least eight different sources. Emails, texts, calls—people saying, “This says cancer and data, so we thought of you.”
I really don’t think we’re missing anything. And we try to be helpful not just to portfolio companies, but also to companies we pass on—through feedback, thesis generation, and business model development.
Brian Smiga: The second superpower is your LP base—smart LPs, cancer centers, and corporations that help with sourcing, diligence, and commercialization.
Ben Freeberg: That’s exactly right. You taught me that a venture fund needs to prove three things: that it can source deals, underwrite correctly, and support companies in a differentiated way.
Our LPs help with all three. They send us deals, help us diligence, and they’ve brought over 20 contracts to our portfolio companies. Startups really want help connecting to revenue.
Brian Smiga: You’re now on Fund II. You beat your target in Fund I. Tell us about Fund II.
Ben Freeberg: Fund I was a $32 million fund. We went out targeting $30 million and ended up slightly over. We had nine strategic institutional partners, along with funds of funds, family offices, individuals like you and Steve, and a few CEOs we backed.
For Fund II, we’ve done our first close on a $50 million fund and were fortunate to be oversubscribed at that first close. It really feels like this strategy is resonating, and it’s the right time to double down.
Brian Smiga: I’ve been saying this for years to LPs and family offices: if you have a subject matter interest and want to move the needle, go find your black-belt VC. Go interview ten and pick the best one. Become an LP in that fund. They’ll take you up the learning curve, provide co-invest opportunities, and more.
If anyone listening has an interest in oncology or views it as a cause within their for-profit investing, they should absolutely have a conversation with you.
Ben Freeberg: Thank you. I appreciate that.
Brian Smiga: That said, how do you think about Fund II in contrast to Fund I? You were a $32 million fund, deployed carefully and at a solid pace. What was the timeline for Fund I?
Ben Freeberg: Fund I consisted of 18 companies, from April 2023 through the end of 2025. We did about five to six deals per year.
For Fund II, the big changes will be slightly larger check sizes, larger ownership stakes, and more scarcity. We’ll probably do four to five deals per year and build a portfolio of 18 to 22 companies, but with larger stakes. The goal is to maintain a strong mix—enterprise SaaS for health systems and payers, along with data-driven care delivery improvements.
Brian Smiga: At this larger size, will you continue to offer co-invest opportunities to LPs the way you have so far?
Ben Freeberg: Yes. We’ve tried to be very disciplined about this. We only offer co-invest in the opportunities where we’re most confident in both near- and long-term success.
We’ll offer co-invest to our LPs for roughly the top quartile of our investments, giving both strategic and financial LPs the chance to double down in the strongest opportunities.
Brian Smiga: So when we invest in a VC like you, we get diversification across 18 to 20 companies, but we also get the opportunity to invest more in companies you’re deeply involved with—board seats, hands-on support—and you only bring us the top quartile.
Ben Freeberg: That’s exactly right.
Brian Smiga: That’s a great model. I hope VCs listening understand how powerful that is. Many funds talk about SPVs and co-invest, but I really appreciate the discipline you bring to it.
Ben Freeberg: It is hard. It takes real time and effort. Even for follow-on investments, we re-underwrite the entire deal. We rewrite the investment memo, redo customer references, and run full diligence again.
That makes it easier for LPs to digest decisions on a deal-by-deal basis. We don’t charge management fees on SPVs, just pass-through costs, and we use Sidecar as our platform. Carry is reduced relative to the fund, because we want to prioritize fund LPs while offering this as an added benefit.
Brian Smiga: As an LP in both your fund and your SPVs, I can say I’m a happy customer.
Ben Freeberg: I appreciate that.
Brian Smiga: Let’s talk about recognition. As a first-check writer, you’re investing before full market validation. What goes into that first phase of recognition for you?
Ben Freeberg: Two things stand out. First, specialization. Once you’ve seen 50 early-detection-for-cancer startups, it becomes much easier to stack-rank the top two or three. That’s very different from seeing one every four years.
Second, we focus on how a company impacts cancer care today and in the future. The team—whether it’s the CEO or another leader—needs to clearly articulate how they get paid today.
We don’t do free pilots. We don’t charge end consumers. Companies need to be paid by pharma, reimbursed by insurance, or paid through SaaS contracts with cancer centers. They also need a clear path to scale over time. You can’t build a large business on a handful of $50,000 contracts forever.
Brian Smiga: That’s a great framework. Let’s talk about results. At your annual meeting, you spoke about real patient impact. Can you share some numbers?
Ben Freeberg: One of our core beliefs is that strong business models drive patient impact. Healthcare organizations prioritize dollars in and out. If you want to be taken seriously, you need a strong financial case.
We’ve now directly touched over 750,000 patient lives through our portfolio companies, and many more indirectly. We’ve also impacted tens of thousands of provider lives—giving physicians and administrators time back to focus on patient care instead of paperwork, prior authorizations, and administrative friction.
We also have very real stories of lives saved through earlier detection, faster trial matching, and quicker authorization approvals.
Brian Smiga: That’s powerful. Can you give us one quintessential example of this impact—one portfolio company that really brings this to life?
Ben Freeberg: There are so many to choose from, but I’ll use Gabbi—G-A-B-B-I—which was one of our first investments. They focus on early detection for breast cancer.
Right now, standard of care doesn’t truly differentiate based on the individual patient. For example, if a woman has dense breast tissue, a mammogram may not be conclusive. Standard protocol might still just be to repeat a mammogram, when what she actually needs is a breast MRI, CT scan, or genetic testing to understand her risk.
Gabbi has now helped thousands of patients get the right test and the right next step in a timely manner. If you catch breast cancer at stage one, survival rates are around 97%. If it’s caught at stage three or four, survival drops below 30%. That progression can happen within 6 to 18 months—and it’s often detectable earlier if the right screening is used.
Brian Smiga: That’s a great example of precision medicine.
Ben Freeberg: Exactly. And importantly, they’re getting paid the right way—through existing CPT codes, insurance reimbursement, and healthcare system partnerships.
Brian Smiga: Is Gabbi something women seek out directly, or is it driven by clinics?
Ben Freeberg: Yes, yes, and yes. Anyone listening who’s interested can go to gabbi.com or reach out to me directly if they want to learn more.
Brian Smiga: Fantastic. Now, Ben, I’ve known you since you were maybe a year or two out of Duke. One thing I learned early is that you’re very funny—and that you do stand-up comedy. You’ve kept that going alongside your venture career.
How has being a stand-up comic helped you as a VC?
Ben Freeberg: It’s helped tremendously, especially in oncology. I’ve had the chance to speak at community oncology conferences and innovation days at major cancer centers.
These are traditionally very serious rooms, and bringing a lighter, more human, community-based energy feels different. We’ve genuinely brought in limited partners, portfolio companies, and co-investors through humor—sometimes through formal stand-up, sometimes just joking in otherwise conservative settings.
It’s also helped in fundraising. I actually included a link to one of my stand-up sets in our Fund I deck. We tracked engagement in DocSend, and it was the only slide that nearly 100% of people clicked on before meetings.
If you can make someone laugh before you meet them, it’s no longer a pitch—it’s a conversation.
Brian Smiga: So since it helps with fundraising and relationships, I assume you’re going to keep doing it?
Ben Freeberg: Absolutely. We publish an Oncology Ventures Substack every month—we just crossed 16,000 subscribers somehow.
The first half covers insights into oncology innovation, and the second half is always a new stand-up comedy bit. I want to make cancer easier to talk about. If anyone has a cancer startup—or even an idea for a comedy bit—please reach out.
I also do corporate events and VC events. I never charge for it. It’s just something I enjoy.
Brian Smiga: So we can hire you for the cost of transportation and coffee?
Ben Freeberg: Exactly. I use Citi Bike, so transportation is free.
Brian Smiga: I don’t know about that—but let’s talk about another move. You’re a New Yorker, born and raised on Long Island, and you recently moved to Austin, Texas. How has that been?
Ben Freeberg: It’s been incredible. The people I’ve met—across oncology, venture, and entrepreneurship—have been so kind and generous.
Instead of just grabbing drinks, people invite me to do sauna and cold plunges, play tennis, or do something active. It’s the same caliber of conversation, but in healthier, more interesting ways.
I still love New York and I’m back about once a month, but being outdoors more and having space has been great. We also met our anchor investor for Fund II in Austin, who’s been an incredible partner and supporter of our portfolio companies.
Brian Smiga: Does that mean when you meet Lance Armstrong, you have to ride a bike with him?
Ben Freeberg: I rode with his group once. We did 28 miles, and I had to stop twice.
Brian Smiga: To do stand-up?
Ben Freeberg: No—I waited on the side while they looped back. It’s a different level of fitness.
Brian Smiga: Alright, let’s wrap it up. You’re on Fund II, first close is done, oversubscribed, and you’re ready to deploy. What do you want listeners to know?
Ben Freeberg: If you see anything interesting in cancer care—an entrepreneur, an article, an idea—please reach out. Subscribe to our Substack. And hire me for your next corporate event.
Brian Smiga: That’s a wrap. Ben, it’s been great working with you, and this was a great conversation. Thanks for your time. This is Brian Smiga signing off from Driving Alpha.
Ben Freeberg: Thank you, everyone.
