biologyimmunotherapyoncologymedicineneurosciencepsychologyAmbient Care
Care when you can’t be there
Machani Robotics
Every breakthrough we have seen happens where two sciences meet: AIVITA's biology on one side, Machani's
embodied AI on the other. Let the two fields drift together before you speak; the statement arrives by itself.
Machani Robotics02/21
CARA : Cancer AmbientRecovery Assistant
An in-home companion robot that stays beside a patient through treatment and recovery, measures how the treatment is lived day to day, and alerts the care team when something changes
Morning
a two-minute check-in, reading pain, energy and mood
Midday
games and meals, reading appetite and engagement
Evening
conversation and Family Link, reading distress and loneliness
Night
sleep tracking, reading rest and restlessness
CC
Cognitive Companion
Companion desktop robot, configured for empathy and ambient care.
Same device · Same platform
CARA is Machani's companion robot, CC, configured for cancer treatment and recovery, starting with AIVITA's patients.
Same device, same platform, a different window to watch.
Machani Robotics · Fact Frame03/21
Distress and isolation
Cancer patients who are depressed die at higher rates - 23% to 83% higher, across 65 studies.
Ungvari et al., GeroScience, 2025
Lonely cancer patients carry a 34% higher risk of death from any cause.
Cheng et al., BMJ Oncology, 2025 · ~1.6M patients
What monitoring brings
Continuous home monitoring cut emergency visits by 62%.
Testa et al., JMIR 2025
Patients whose symptoms were watched between visits lived five months longer.
Basch et al., JAMA 2017
But they won’t wear it
More than half of cancer patients stop wearing the device - and the sickest stop first.
JMIR mHealth & uHealth, 2020
The list builds in place, one fact per click. Optional spoken line: depression and cachexia take more
patients than the cancer itself.
FLAG: Cheng et al. 2025, confirm exact wording and DOI before release.
Machani Robotics · The problem04/21
The problem is the silence between visits.
Visit
Visit
Visit
Silence
Silence
CARA · monitors continuously
With CARA, we solve for both.
Loneliness & distress
A companion patients keep
Surveillance
Nothing to wear, nothing to log
A visit sees a sliver; the rest is silence. With CARA the whole line is seen, every day.
And CARA solves for both: the loneliness, and the surveillance.
Machani Robotics · Our partner05/21
Our partner, AIVITA Biomedical.
AIVITA Biomedical is a market-leading immunotherapy pioneer, delivering personalised cancer treatments that uniquely isolates tumor initiating cells to achieve unmatched clinical survival rates.
Glioblastoma
The most aggressive cancer that starts in the brain.
57%
increase in survival over standard-of-care treatments.
Phase 3 awarded
Melanoma
The deadliest form of skin cancer.
83%
two-year overall survival rate.
Phase 3 awarded
What slows their trials
Once patients go home, follow-up is slow and manual.
Nurses phone each patient for updates.
Follow-up is hard to keep up between visits.
Long turnaround from patient to trial data.
Hence, CARA × AIVITA
Term sheet signed for 3,600 CARA units over 3 years.
Machani Robotics · The moment · Why now06/21
Once patients leave from the clinic. The observation shouldn’t leave with them.
In the trial
every visit, every scan
After approval, today
a short call every 3–4 weeks
After approval, with CARA
every day, in the room · 24/7
How closely the patient is watched
Approval · The Bahamas
Who watches
The trial team, visit by visit
A nurse, by phone, every 3–4 weeks
CARA, every day, in the room
Who pays
The trial budget
The surveillance budget
The same budget
What it captures
Efficacy and safety in a controlled cohort
A short recall, often 'alive / not alive'. Rarer side effects go unseen.
Quality of life, symptoms and safety signals, every day
Tell it as one story. In the trial we watched every patient closely, and that is how we know the therapy works.
Approval ends the trial, and today's answer is a short call every 3–4 weeks. The rarer side effects only show up
once thousands are treated, which is exactly when we watch least. CARA puts the watching back, for the same budget.
FLAGS: Bahamas approval wording and date once AIVITA announces it · can the three markets be named ·
nurse-call cadence of 3–4 weeks is assumed (CEO office to confirm).
Machani Robotics · What we built · The Solution07/21
We built the Companion that Cares.The Intelligence that watches over recovery.
Empathy
Ambient Care
Confidante
Psychological coach
Life story and legacy
Games and play
Nutrition and breathing
Quality-of-life instruments
Symptom triage
Personal baseline
Early warning
Safety signals
The non-consensus claim: continuous signal is a trust problem, not a sensor problem. Embodiment is how you solve trust.
FLAG: the photo shows CC with an older woman; use an oncology-context studio photo if one exists (no AI imagery).
Machani Robotics · What we built · What it senses08/21
Six families of signal. One personal baseline.
What SONA reads, from one robot, with nothing to wear. Each family arrives in the wave it can be relied on.
Illustrative
What it measures
In cancer recovery · CARA
On the roadmap
Illustrative data. Indications are what each signal is studied for; clinical use follows validation on our roadmap.Wave 1Wave 2Wave 3
Six families of signal from one robot, with nothing to wear. Click through A to F. Sleep and the conversation
family (including nutrition) arrive in wave 1; physiology and movement in wave 2; the full cognitive battery in wave 3.
Waves are when features ship; they are not the roadmap's four stages.
Charts are illustrative, not patient data.
FLAG: engineering to confirm the wave of each family.
Machani Robotics · What we built · SONA09/21
Every signal meets one intelligence.
The robot is the door. SONA turns every signal into action for the care team and AIVITA.
Six families of signal
Heart
Voice
Movement
Sleep
Mood
Cognition
SONA
The intelligence layer
Personal Baseline & Trends
Fusion & Symptom Triage
Early Warning & Safety Signals [WIP]
Family Link App
Patients & Families
Never alone between visits.
A companion every day
Including the weeks when visitors can’t come.
Family kept close
Photos and notes from family, shared and talked about.
Questions answered
In AIVITA-approved language; anything more goes to a person.
AIVITA Record
AIVITA & Pharma
Post-marketing surveillance, from the first patient.
Four measures, every day
Quality of life, pain, happiness and KPS, from published instruments.
A safety file that builds itself
Symptoms graded and logged, with onset and response.
Evidence for what comes next
The record behind prescriptions, trials and FDA clearance.
Care Dashboard
Oncologists & Nurses
Problems caught before the next visit.
Same-day triage
Flagged symptoms reach the team the afternoon they appear.
One view of the patient
Trends against the patient’s own baseline, not a population average.
Time aimed where it matters
Daily check-ins replace routine follow-up calls.
The crux of the deck: one robot, six signal families, one intelligence. Let the flow run. Every dot is a signal
from the patient's day; SONA learns their baseline, fuses the signals, triages symptoms and raises early warnings.
Then click each surface: the family, AIVITA's programme record, the care team. Each gets what it needs from the same stream.
Machani Robotics · What we built · Measuring what matters10/21
AIVITA’s advantage is how patients live.CARA makes it measurable.
Every day
“How are you doing today?”
General quality of life
ESAS-r wellbeing · PROMIS-29 monthly
Every day
“How much does it hurt?”
Pain, 0–10
ESAS-r pain · PROMIS pain interference
Every week
“Are you feeling happy?”
Happiness
WHO-5 · daily mood and anxiety
Every month
“Can you manage your day?”
Karnofsky Performance Status
KPS interview · ADL / IADL check
What it brings out
AIVITA’s treatment preserves daily life where harsher treatments take it away. Nothing today records that between visits. AIVITA named four things to track; CARA asks them in plain conversation, in about two minutes a day.
Why this slide is here: monitoring alone is a cost; this turns it into evidence for AIVITA. The patient answers a
friendly question; AIVITA gets a published, validated measure. Every number comes from an instrument asked word for
word, so it stands up to a regulator. This record is what stage 2 (efficacy and prescriptions) is built on.
FLAG: "preserves daily life where harsher treatments take it away" paraphrases AIVITA's own framing; confirm wording.
Machani Robotics · What we built · Post-marketing surveillance11/21
One patient. One symptom. Two very different weeks.
An illustrative patient, ten days after treatment. The same symptom, followed today by nurse call, and with CARA.
Day 10
Day 10, same afternoon
Day 18
Day 28
Today · nurse call
Appetite drops, stomach unsettled. Nobody asks.
Nurse call: “Doing okay.” The details are vague by now.
Seen at the next visit, more severe. Logged weeks after it began.
With CARA
“I haven’t felt like eating.” CARA asks the matching PRO-CTCAE items, word for word.
Graded and logged. It matches AIVITA’s flag list, so the care team is alerted. A nurse calls the same day.
Daily check-ins follow it as it settles. Nutrition support continues.
Already on record: onset, grade, response. Part of AIVITA’s safety file.
Across thousands of patients, these same-day records become the safety signal small trials cannot see. This is post-marketing surveillance with pharmacovigilance built in.
Walk it left to right. Same patient, same symptom. In the top lane the first time anyone hears of it is a phone call
a week later, and the detail is gone. In the bottom lane it is graded and with the care team the same afternoon.
Then scale it up: thousands of these records are what pharmacovigilance is made of. Phase 1 is preliminary,
conversational triage with human review.
FLAGS: label as illustrative · clinical team to check the symptom and grading fit AIVITA's regimen ·
AIVITA still owes the flag list, escalation route and PRO-CTCAE regimen.
Machani Robotics · Where it goes · The roadmap12/21
The roadmap: each stage unlocks the next.
We enter as the companion patients keep. We become the layer cancer care runs on.
Now · stage 1
Surveillance
Patients - a companion, 24/7
AIVITA - daily QoL and KPS record
AIVITA - safety signals, same day
$10,000 per unit, from AIVITA
Next · stage 2
Efficacy and prescriptions
AIVITA - cachexia and depression care
AIVITA trials - a CARA arm
AIVITA - more prescriptions
More units as prescriptions grow
Unlocked by the stage 1 record
~2 years · stage 3
Every company, every treatment
Pharma - any cancer therapy
Pharma - any sponsor, any market
Patients - CARA beyond AIVITA
Licences per sponsor
Unlocked by FDA clearance, ~2 years
At scale · stage 4
The data, governed
Anonymised, consented, compliant
Cohort data stays with its owner
Interaction data, generalised
Research - real-world evidence
Data programmes with each data owner
Unlocked by scale across therapies
SONA · beneath every stagePatientsAIVITAPharmaResearch & public
QoL: Quality of life · KPS: Karnofsky Performance Status · FDA: US Food and Drug Administration
Four stages, each unlocked by the one before. Stage 1, now: post-marketing surveillance with preliminary
pharmacovigilance, paid per unit by AIVITA. Stage 2: cachexia and depression care and a CARA arm in AIVITA's trials
prove the combined benefit, and 360° care becomes a reason to prescribe. Stage 3: FDA clearance in about two years
opens CARA to every company and every cancer treatment. Stage 4: the data, governed. Cohort-level data stays with its
owner, always; only anonymised, consented interaction data is generalised to make every robot better.
Dr Keirstead's own instruction to us: reliability before capability. Stage 2 is a measured outcome, not a promise.
If asked: care teams see patient-linked data, because a clinician can't act on an anonymous alert; research sees
only anonymised aggregates. Raw conversation, audio and images are processed on the robot and never leave it.
Named comparables if asked: OncoBuddy (4baseCare), Belong.Life, ePRO tools; ElliQ among companion robots.
FLAG: draft scoring, review each dot with the team.
Machani Robotics · Why us · The moat14/21
The moat compounds with every stage.
Each stage adds a barrier the next competitor would have to clear.
Now
Next
~2 years
At scale
Stage 1 · Now
Trust that is earned
Patients keep CARA for the relationship. Every conversation makes it a better companion.
Stage 2 · Next
Evidence inside AIVITA’s protocol
Validated instruments, flag lists and a CARA arm in trials, built with AIVITA’s clinical team.
Stage 3 · ~2 years
FDA clearance
A cleared device on clinical data. Years of work for anyone starting today.
Stage 4 · At scale
The longitudinal record, governed
Anonymised, consented records at a scale that does not exist today. Cohort data stays with its owner.
The moat is not one thing; it accumulates. Trust first, then evidence built inside AIVITA's protocol, then FDA
clearance in about two years, then a longitudinal record nobody else has. Say the data line out loud: cohort-level data stays with its owner;
Machani generalises only anonymised, consented interaction data to make every robot better.
Machani Robotics · Why us · Engineering depth15/21
Seven years bought us the hard part.
RIA is an expressive humanoid on the same cognitive core as CARA
61
degrees of freedom
30
in the head alone
Actuated
facial skin
On-board
edge inference
Paid pilot signed at UC San Diego’s Sanford Stem Cell Clinical Center, under an approved IRB consent protocol.
“
RIA unburdens each provider from repetitive tasks that currently take 30–40% of their attention away from patients.
Dr Anna Kulidjian, Orthopedic SurgeonScripps Health
The students lit up with RIA — more open to communicating with her than with an actual human being.
John McCarthy, Chief Program OfficerTERI Campus of Life
RIA is the reason we can build CARA, and where the platform goes next.
Keep RIA subordinate: it proves the team ships clinical-grade hardware into a US academic medical centre.
Machani Robotics · Why us · Added benefit16/21
One cognitive core, many more places to care.
Every cancer therapy
Any sponsor, any regimen
After FDA clearance, the surveillance layer serves every cancer therapy.
Senior living · CC
The companion that cares
FGCU, Shell Point and Babcock Ranch in active discussions, onboarding targeted 2027.
Expressive humanoid · RIA
Clinical and community settings
A paid pilot at UC San Diego’s Sanford Stem Cell Clinical Center.
Other recovery journeys
The same device, a new window
Transplant, cardiac and post-surgical recovery on the same device and platform.
The same platform beyond AIVITA: every cancer therapy after clearance, senior living with CC, RIA, and other
recovery journeys.
FLAG: "other recovery journeys" is a direction, not a plan; confirm we want it named.
Machani Robotics · Why us · Team17/21
The Team Behind CARA
Machani Robotics · The business · Business architecture18/21
The Commercial Outlook
Now · Unit contract
$10,000
per CARA unit
Scale · With AIVITA
1,200 → 2,400
units in programme years 2 and 3.
Later · Every sponsor
Licences
for other cancer therapies, post FDA clearance.
Together we define the future “standard of care”
24/7
surveillance with pharmacovigilance built in
Companionship that keeps patients engaged, validated quality-of-life instruments, and same-day symptom triage, whose value grows with every patient.
Preliminary until the CEO office updates the model. The $10,000 covers the surveillance and pharmacovigilance layer,
not just the hardware; its value grows with every patient.
FLAG: how Machani earns from data programmes run with the data owner (revenue share, platform fee).
Machani Robotics · The business · Financials19/21
Revenue reaches $169M by 2030.
20262027202820292030
$Millions
2026
2027
2028
2029
2030
CC — senior living
—
—
10.9
42.9
97.1
CARA — oncology
0.2
12.0
24.0
47.9
71.8
Total revenue
0.2
12.0
34.9
90.8
168.9
Gross profit
0.1
8.8
22.9
61.0
116.8
Gross margin
65.9%
73.5%
65.5%
67.2%
69.1%
Operating expenses
(1.7)
(8.4)
(13.1)
(28.9)
(46.0)
EBITDA
(1.5)
0.4
9.7
32.1
70.7
Net income
(1.6)
(1.0)
6.5
23.2
51.8
CC — senior livingCARA — oncologyEBITDA
Say the CARA/CC split before they find it. A sophisticated investor opens the model and sees
negative senior-living EBITDA in minute four. Disclosed it is strategy; found it is a hole.
FLAGS to hold in mind: the CARA line beyond 2028 has no basis in the term sheet (which caps
the initial deployment at 20 units and forecasts 1,200 and 2,400 non-bindingly); the model's
own dashboard labels its CAGR 2026–30 when the formula computes 2027–30.
Volumes: 22,640 active CC bots and 124 communities by 2030; 15,040 cumulative CARA units.
Machani Robotics · The business · The ask20/21
The Ask is for $30M
$30.0M
Ask
US manufacturing facility and production tooling15.0
Engineering and clinical analytics hiring5.0
Go-to-market across AIVITA’s markets4.0
Clinical validation, regulatory (FDA) and quality3.0
Working capital and COGS ramp3.0
$30.0M
Milestones
Phase 1 complete with ten units deployed
CARA live across AIVITA’s first markets
Pharmacovigilance layer live in service
Cachexia monitoring shipped as an update
FDA submission prepared for certification
"One-time" is Dr Keirstead's framing: raised once, then revenue carries the business. Preliminary until the CEO
office updates the model. Close with the four names.
