21 October 2019

How are US Start-Ups Fighting Cancer with Innovation and Early Detection?

By Nathan Rigby

A new generation of start-ups are revolutionising cancer diagnosis, detecting disease before patients even show symptoms with liquid biopsy tests.

This proactive approach is crucial in cancer treatment, with early detection increasing treatment success rates and saving lives.

Liquid biopsy is a non-invasive alternative to surgical biopsies, which uses a blood sample to test for traces of cancerous DNA. This can then be used to provide insight into the treatments that will work most effectively for each patient.

Throughout global diagnostics, especially in the US, there’s been a dedicated effort to achieve early cancer detection. This has been reflected in the market by Exact Sciences’ huge $2.8bn acquisition of genomic diagnostics maker Genomic Health.

However, it’s not all about the major players.

I’m also seeing many exciting US start-ups emerging in this space, leading me to think that this region is quickly becoming the home of innovation for early cancer detection diagnostics:

Thrive

New kids on the block, quite literally, Thrive’s team is made up of some of the biggest names in cancer diagnosis at Johns Hopkins University including Bert Vogelstein, Kenneth Kinzler and Nickolas Papadopoulos.

There is serious excitement surrounding their CancerSEEK technology, having raised $110m worth of series A funding.

Unlike many screens today, Thrive’s CancerSEEK is designed to find multiple cancer types from a single blood draw. When integrated into routine medical care, alongside other existing cancer screening tools, the tests will provide better and earlier detection to help save lives.

Developed to combine cutting-edge liquid biopsy technology with a machine learning engine, the test will improve with every person that’s screened.

It is currently being evaluated in a 10,000-person study in collaboration with the Geisinger Health System in Pennsylvania and New Jersey, before being brought to the commercial market.

CancerSEEK is just the beginning. Thrive are also developing a comprehensive and integrated service that includes result interpretation, follow-up testing, confirmed cancer diagnosis and facilitation into oncology care – acting as a partner for healthy patients and physicians throughout.

Freenome

AI genomics biotech company, Freenome, are also harnessing the power of machine learning to provide earlier cancer diagnosis.

With their research originally starting in prostate cancer, Freenome have since turned their focus to colorectal cancer – for which they’ve received $160m worth of funding.

Colorectal cancer is the second most lethal cancer in the US, despite having 90% five-year relative survival rate when it’s detected early.  

Right now, Freenome are developing a test for multiple cancers, including colorectal, which combines AI with the development of proprietary assays.

By drawing samples of cell-free DNA from the blood and treating it with methylation and protein biomarkers, Freenome can apply machine learning techniques to identify additive signatures that can improve the accuracy of early cancer detection.

Using multiple inputs, rather than just looking for genetic material coming off tumors, the San Francisco-based company claim that their tests can detect cancer earlier than more invasive, traditional tests.

I’m certain that further investment to support Freenome’s research and tests will lead to major growth for the company and, most importantly, earlier cancer detection and more effective treatment for patients.

GRAIL

GRAIL have also received serious investment, possibly the largest amount I’ve seen while recruiting in diagnostics.

Backed by Amazon, Bill Gates and Illumina, privately owned GRAIL have raised $1.6bn since 2016 – making it one of the top biotechnology unicorns.

While these funds are crucial, the support from next-generation-sequencing (NGS) kings, Illumina, is equally valuable for GRAIL - with NGS an integral part their blood tests.

Recent successful clinical trials showed the GRAIL test, which combines NGS with machine learning, to pick up a multiple deadly cancer types at stages I-IV with a high degree of accuracy, while also determining the tumor origin for 93% of cases. Its early detection test also detected a total of 20 cancer types with a low false-positive rate.

These data are preliminary, however, also very promising and provide insight into why so much excitement surrounds GRAIL.

With some of the best talent in biology, clinical science, bioinformatics, deep learning and engineering at GRAIL’s disposal; the potential is huge. Even further backing could see them competing with exact science’s and genomic health’s new super entity.

A 38% CAGR is now expected within the next five years for the liquid biopsy market in support of early cancer detection.

I’m so pleased to see serious investment support this space. Everyone knows someone who’s been affected by cancer. With US start-ups innovating at such a rate, we’re getting closer and closer to beating this disease for good.

Although the US provide the heartbeat of innovation in this space, there’s no doubt in my mind that this is a global effort to beat cancer. I appreciate that there are many important companies doing vital work elsewhere – who I’d love to learn more about.

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By Nathan Rigby

Nathan Rigby works globally, specialising in technical and non-commercial positions in in-vitro diagnostics. He enjoys exploring the humanitarian benefits of IVD, such as within the development of new rapid diagnostic tests for infectious diseases.

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