Bengaluru: Mumbai-based Epigeneres Biotech Private Ltd, in collaboration with Singapore-based Tzar Labs, has developed the world’s first pan-cancer imminent-detection blood test. With just a few drops of blood, the test makers say they can detect cancerous stem cells before tumours form, with nearly a 100 per cent accuracy.
The potential of targeting stem cells to detect imminent cancer was published in a peer-reviewed paper as an article in January this year. While there are further trials planned, the screening test is available in the team’s Mumbai lab.
Ashish Tripathi, founder of Epigeneres and CEO of Tzar Labs, sat down with Sandhya Ramesh to discuss the scope and importance of this new cancer test.
SR: Can you tell us about your test?
AT: There are a couple of global firsts we’ve achieved. This is the first pan-cancer blood test, and it can detect [cancer cells] earlier than any known technology because it detects cancer in situ prior to being positive on a PET [positron emission tomography] scan [a type of imaging test]. But our test can detect when mutations have happened in a primary organ and cancer cells are proliferating.
Not just that, we can tell you which cancer [cell is growing] and where it is going to spread straight from a blood test. This is the first prognostic test for cancer from a blood test. We can even tell how long you would be free of cancer in a safe zone within the next year, as we know the pace at which these markers grow.
All that is needed to be done is to take a regular blood test every year to evaluate your risk of cancer for one year.
SR: How does the test work?
AT: We detect cancer through a causative marker rather than a resultant marker, which biopsies do. When studying cancer pathways, we came across a very interesting realisation — that our molecule was interacting with a subpopulation of pluripotent stem cells. These cells would then undergo epigenetic changes, effectively becoming cancer stem cells, which then grow into cancer cells. Billion of cancer cells come together to form a tumour; remember that one cubic centimetre tumour has a billion cancer cells.
Once the tumour forms, it sheds its outer layers, called circulating tumour cells. When they break down, they release their contents. Instead, what we stumbled upon was a causative marker, because these stem cells we notice will turn into cancer in the future. We realised we could isolate those cells of interest and actually measure that specific change. So we know how to distinguish healthy pluripotent stem cells from stem cells that would turn into cancer due to observed epigenetic changes.
This is the fundamental reason why we have a very high accuracy. We are not the smartest guys, we got lucky. The stem cells were also not originally discovered by us, we have known of their existence because of work done by scientists around the world.
SR: How confident are you in saying that the test produces 100 per cent accurate results? What did the study find?
AT: Our study used 1,000 participants and we got this unique result where there were no false negatives, no false positives, and there were 25 different cancers detected. But we haven’t stopped here. We are doing a study with the NHS involving 10,000 participants and trying to get studies done in India and US also.
The reason we have an advantage is because our cells of interest show up in the blood test much earlier than a tumour shows up.
Cancer is a complex disease, there are 200 different types and 3,000 subtypes of cancer. So no study has covered all types of cancers. In our 1,000 people India study, there were 25 different cancers detected. The only reason we believe that we may have a pan-cancer test is because we detect epigenetic changes in stem cells, which is the common point for the origin of all cancers.
SR: What is the test process after blood sample is collected and how are results different from those of other tests like for breast cancer (BRCA)?
AT: We take 10ml of blood for the test and look for molecular markers. We are looking to automate certain portions of this so that we can increase the number of samples we can process. At the backend, there is a need for a lot of process innovations.
Tests like BRCA breast cancer gene detection tests give a person the propensity to develop cancer and whether they require regular monitoring. Our test tells whether cancer is present, imminent, or absent.
We think it has major use for oncologists as a screening test and providing appropriate interventions.
SR: What are the next plans for the test?
AT: We are looking to first conduct NHS [National Health Service, UK] trials because we need that validation and support for our innovation in India and internationally.
We believe the use case of detecting imminent cancer will be of major interest because cancer is weak at that stage and interventions can be done relatively easily. This would be an ideal scenario. All of us have been touched by cancer and know at least one person who has had it. We are dealing with a disease that goes downhill very, very fast. It is the second largest killer in the world.
Most of our first focus will be on some of the most terrible cancers like pancreatic, colorectal, or ovarian cancer. These have low survival rates after detection, and we plan to go cancer by cancer.
SR: Where in India can I get your test?
AT: Currently the only lab that can do this is our mobile lab in Mumbai. We also have agreements with a lab in the UK and in discussions with one in the US as well.
(Edited by Poulomi Banerjee)
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