Startup Mantra: Making cancer detection more accessible

In May 2022, the Indian Council for Medical Research released a report on the burden of cancers in India. It is projected that the number of Indians suffering from cancer will increase to about 3 crores in 2025. Continuous monitoring of cancer status (every 3-4 months) will ensure that any relapse of cancer is caught early enough for the patient to seek effective treatment. however, most people find it unaffordable to undergo such tests.

Actorius Innovations and Research Pvt Ltd (AIR), a Pune-based research and development company, has created a novel biomaterial having critical applications in the life science, drug delivery and medical diagnostics field.

Founded in 2013 by Jayant Khandare and Aravindan Vasudevan, the company has launched its first product, the ‘OncoDiscover Liquid Biopsy Test’, a minimally invasive test which can be performed multiple times requiring 1.5ml blood volume. This test is an excellent tool for therapy monitoring and can be performed at multiple time points such as during initial check-up, pre-surgery, post-surgery, post-chemotherapy and during follow-up. Since Circulating Tumor Cells (CTC) present in patient blood are enumerated (counted) by this test, it becomes a quantitative benchmark to monitor disease progression and therapy effectiveness.

In the beginning…

Khandare who is the managing director and chief scientific officer of the company earned his bachelor’s and master’s degree in pharmacy, Khandare received a PhD (polymer chemistry) in chemical engineering from the National Chemical Laboratory, Pune in 2003. He has worked extensively on targeted nano polymeric drug delivery systems for cancer. The company’s co-founder Vasudevan has a master’s degree in chemistry and a certificate in business studies (marketing). Vasudevan has worked as a scientist in the pharmaceutical and drug discovery industry. The duo had met during marathon events organized by the company they worked together earlier.

Khandare says, “The Department of Biotechnology (DBT) promotes science-based ‘high risk’ innovation in India. Innovation can be simple, frugal or complex, but we are completely lacking in it. We have the best scientists, but they are engaged more in academics and fundamentals rather than products and innovations. Neither scientists nor venture capitalists want to take risks in science startups and hence there are very few success stories in healthcare innovation in India.”

“For example, we have neither discovered any drug nor have we done anything innovative in diagnostics in cancer. We import medical devices worth more than $10 billion annually in India. We have a lot of unmet needs and challenges but we didn’t have medical rules or the network and ecosystem for startup companies to fulfill them. Similarly, India has very good doctors but due to the heavy patient load, they are not inclined towards doing research activities. I was working in National Chemical Laboratory (NCL) and after completing my PhD I went to the USA. While deliberating on the innovation ecosystem of India, I decided to return to India and prove that innovative medical devices and products can be developed indigenously,” he added.

Early detection and surveillance

In India, a patient comes to a doctor or hospital, gets diagnosed with cancer and further treatment like chemotherapy, and radiation is done. Khandare says, early detection, treatment and patient management and surveillance are three important aspects, of which we are good at treating patients.

“There are a lot of misconceptions regarding early detection of cancer using genetic tests. Doctors cannot treat such patients unless PET (Positron Emission Tomography) scan and biopsy are done. Early detections are being made possible by science-based companies but clinicians don’t have any solution for it and hence we must make early detection more ‘realistic’,” he said.

“On the surveillance front, we are lagging because we do not monitor patients once the disease is considered to be ‘cured’. There are 50 lakh cancer survivors in India. Another statistic says 90 percent of cancer patients succumb to the disease because of unnoticed early metastasis (spreading of loosely bound cancer cells from primary organs to a distant organ). This means they have less chance of survival if not monitored regularly. A PET/MRI (about 8-10 mm) scan often misses the presence and spread of cancer cells (10-30-micron size) in the body. Being negative in PET/MRI scan does not mean the patient is disease-free,” Khandare stated.

Technology development

Since 2004, a cancer diagnosis blood test in the US was being used to detect capture and enumerate the Circulating Tumor Cells (CTC) in 7.5ml volume of blood, with a turnaround time of 10 days. It was also used to predict the survival period of patients.

“The test in the US was priced at 1.5 lakh and was unaffordable for Indians. CTC technology helps to avoid intervention by surgery to take tissues. But for that, we need advanced biomaterials, antibodies, machines, AI systems, computation powers, etc. We started working on this technology to develop our indigenous biomaterial. For the initial two years, we worked on material sciences at the NCL Venture Center and also got a grant of 40 lakh from DBT. But we had to wait until 2019 to get the indigenous technology and device developed new Medical Device Rules 2017. This initiative was actively supported by FDA Maharashtra. Dr Harsha Vardhan, Former Union Health Minister launched the test in India” Khandare informed.

OncoDiscover

The OncoDiscover Liquid Biopsy Test is an indigenously developed, patented in-vitro diagnostic test which has got Drugs Controller General of India (DCGI) approval for marketing in India. This test is a highly specific and sensitive test that can detect, capture and enumerate circulating tumor cells in a very low volume of blood.

Elaborating more on this technology, Khandare said, “We process 1.5 ml blood sample. Using advanced biomaterials, we identify cancer cells from more than a billion cells present in that sample. We had taken ethical permission from Tata Memorial Hospital, Mumbai to conduct clinical trials. The biomaterial and specificity required are very high for this kind of test and we have managed to achieve it.”

Future plans

Sharing his future plans, Khandare said, “Currently valued at 110 crore, we are now putting our sales and marketing team for OncoDiscover in place. Apart from OncoDiscover, we are working on four other tests for cancer cells. Of those, the first test will be launched in December 2022 which will allow oncologists to decide the immuno-oncology treatment decisions which can extend and save a patient’s life. We are also working with some US companies and plan to start our lab there. Our ultimate objective is to bring the 50 lakh cancer patients under surveillance and for that, we are trying to bring down the test cost by one-third.”

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