The numbers are startling and depict a sad state of affairs. Each year about 1,50,000 women are detected with breast cancer in India, with about 40-50% patients in the early stages (Stage 1 & 2). There are currently no affordable tests that can predict whether the cancer will return in a patient. Due to this, many early-stage breast cancer patients undergo chemotherapy to avoid cancer recurrence. As a result, patients with low risk of cancer recurrence are often over-treated and consequently bear various toxic effects of chemotherapy treatment.
“With modern science, treatment of breast cancer isn’t as frightening as it may have been earlier,” says Manjiri Bakre, CEO and founder, OncoStem Diagnostics. “Today, not all women diagnosed with early-stage breast cancer need to undergo chemotherapy.” OncoStem Diagnostics is an oncology-focused start-up that has developed a promising test, called CanAssist-Breast, that can spare breast cancer patients from chemotherapy. “It is designed to classify patients depending on the probability of recurrence. By analysing the patient’s tumour biology, CanAssist-Breast identifies patients at ‘low-risk’ or ‘high-risk’ for recurrence to assess the benefit of adding chemotherapy to their treatment.”
The test provides additional information about the tumour by looking at the activity of proteins present in it. Along with the existing pathology reports, this test can help identify the likelihood of the cancer returning post-surgery. “CanAssist-Breast can spare potentially over 60,000 breast cancer patients in India and 1 million patients worldwide every year from the perhaps unnecessary severe side effects and associated costs of chemotherapy,” says Bakre.
Tech to the rescue
OncoStem uses gold standard proteomics based technology called Immunohistochemistry to perform the test. The technology is based on the detection of highly specific and quantitative antigen-antibody reactions that are measured specifically in tumour cells. OncoStem’s patented combination of five bio-markers analysed using IHC (Immunohistochemistry) are used in conjunction with three clinical parameters (tumour size, grade and Node status) by a proprietory machine learning based algorithm to obtain a CanAssist-breast risk score. The risk score is indicative of risk of cancer recurrence.
Bakre explains that chemotherapy is known to benefit only a minority (~<15%) of early-stage patients. “Chemotherapy is beneficial in advanced stage patients and also as palliative treatment. We are trying to solve the problem of accurately assessing the risk of cancer recurrence among early-stage patients that will help them plan optimum chemotherapy treatment,” she informs.
OncoStem Diagnostics has raised a total of $9 million from two investors (Sequoia Capital and Artiman Ventures.) It operates through a partner-based approach to the market. The partners are large diagnostic chains that have an established sales team and a strong support network to collect samples. “We are currently working with 10-plus hospital partners, two large diagnostic chains and a direct sales team engaging clinicians pan India. SRL and Dr Lal Path are our two partners. We are also partnering with small regional labs that have good access to the local markets,” said Bakre, adding, “through partners, we currently have access to 100+ sales personnel who reach out to 1500+ clinicians on a regular basis.”
OncoStem has launched the test in neighbouring countries such as Bangladesh and Sri Lanka as well. “This year, we will offer the test in South East Asia and Middle East. Some reputed hospitals in the US and Europe have signed up for the validation of the test,” she informed, adding, “We are also working on a second test for triple negative breast cancer and similar tests for oral and colorectal cancer.”