Finding a cure for cancer has been a daunting prospect for both physicians and scientists. Strides in various genomics technologies have revealed the mutational landscape of cancer and heterogeneity within tumors. Despite availability of therapies that target specific mutations, the biggest road-block has been the prediction of accurate biological response to these treatments. Riya Binil writes about a pioneering precision medicine technology called CANscript developed by Mitra Biotech that intends to overcome this huge obstacle. This company has developed a unique system of culturing tumor cells together with its microenvironment thus mimicking the cancer ecosystem within the body. Different combinations of treatment are tested with this system to identify those that work with greatest efficacy. With CANscript Mitra Biotech has taken a giant leap in the fight against cancer and we wish them great success.- Shayu Deshpande
Mitra Biotech has expanded the horizons of cancer treatment by delivering a truly personalized patient-specific cancer care through their proprietary CANscript technology. CANscript is a fast, cost-effective, and powerful technology that predicts a patient’s response to cancer treatment with high correlation to the clinical outcome, thus aiding in the elimination of ineffective treatments. In an exclusive interview with Kirk Mundy, Senior Director, Worldwide Clinical Marketing at Mitra Biotech, he talks to us about Mitra’s CANScript technology and about their commitment to improving cancer care.
Mitra Biotech, spear headed by Mallik Sundaram and Pradip K Majumdar, was established in 2010 with a mission to develop and deliver ‘more efficient and effective’ strategies for cancer treatment. The company is headquartered in Woburn, MA, USA and runs an active laboratory arm in Bengaluru, India.
— Biotech Week Boston (@BiotechWkBoston) September 20, 2016
Need for personalized cancer care
Cancer is a devastating disease caused due to abnormal division of cells in the body. Aberrant cell growth in cancer can be a result of random mutations in DNA that are instigated by environmental and/or genetic factors. Cancer treatments are provided based on the type, stage (early or late) and grade (low or fast growth rate) of the cancer cells. Currently, available cancer treatments include non-targeted interventions like surgery, chemotherapy, radiation therapy, stem cell transplant as well as targeted therapies such as immunotherapy, hormone therapy and use of specific drugs to block the growth of cancer. These therapies are however, not free of drawbacks. While non-targeted therapies kill both cancerous and healthy cells leading to side effects, targeted treatments become ineffective over time as cancer cells become resistant to the drugs or re-grow utilizing alternate pathways. Therefore, it is important to deliver the right combination of therapies that kill cancer cells with high efficacy. This is very challenging as there is no defined approach for the use of combination treatments. Hence, there is a need to develop tools that will help physicians select appropriate patient-specific cancer therapy.
Precision medicine is a form of personalized cancer therapy, based on understanding of the patient’s genetic background. In this therapy, clinicians recommend treatments to a patient depending on population studies, where patients are grouped by factors such as similarity in the treatment history, genomic profile and tumor type or tumor progression. However, each cancer can be idiosyncratic due to differences in DNA mutation profile, tumor microenvironment, vasculature, and immune system. Therefore similar precision therapies may have low success rate in patients sharing common features. This calls for a stricter personalized cancer treatment approach that is specific for each patient and takes into consideration the characteristics of not only the tumor but also its microenvironment. This is where Mitra’s approach ‘CANscript’ falls into place. CANscript is currently the only available ‘truly personalized’ cancer therapy of its kind.
The isolated cancer cells are grown under controlled conditions on culture dishes ex-vivo using a suitable matrix and patient serum for optimal cell growth. This recreated tumor microenvironment is then subjected to various combination of drug treatments following which the tumor response is scored. The tumor response is measured through various parameters such as changes in morphology, metabolism, viability and necrosis.
CANscript involves efficiently recreating a tumor’s microenvironment in culture (ex-vivo). The technology utilizes a tiny amount of tumor or cancer cells obtained via biopsy and blood of the patient. The isolated cancer cells are grown under controlled conditions on culture dishes ex-vivo using a suitable matrix and patient serum for optimal cell growth. This recreated tumor microenvironment is then subjected to various combination of drug treatments following which the tumor response is scored. The tumor response is measured through various parameters such as changes in morphology, metabolism, viability and necrosis. The data output obtained from these measurements is then subjected to analysis by a proprietary algorithm to predict clinical response to the respective treatments in the form of M-score. An M-score greater than 26 is indicative of high probability for that patient to respond well to the same treatment. The tumor microenvironment along with the algorithm forms the CANscript technology. The full procedure of CANscript testing is completed within seven days.
— Medidata (@Medidata) September 22, 2016
CANscript has been tested and validated in nearly 2000 patients with close to two dozen tumor types being included during the development. Moreover, CANscript has been tested for hundreds of drugs and drug combination across multiple drug classes. Data from clinical studies show that CANscript predicted treatments have greater than 90% correlation with clinical response. An important consideration here is that the therapies to be tested on the tumor are suggested directly by the patient’s oncologists, in which case, factors like therapeutic availability, cost, time, toxicity and other side effects have already been evaluated. Once results are generated, the physician considers the M-score for each of the tests and selects a therapy based on the experience and patient’s treatment history. Thus, CANscript aids in eliminating ineffective therapies thereby sparing patients from unnecessary toxicity from the failed treatments. CANscript saves time and is cost-effective for patients both of which are important factors, suggesting that it truly resembles a personalized form of cancer therapy.
Currently, Mitra Biotech works with clinicians from across 40 different institutions in India for CANscript testing. Kirk mentions that the patient has to go through their doctor to utilize the testing. One of the major challenges is that physicians are reluctant to shift from conventional treatment procedures to more innovative methods. Providing convincing data from controlled clinical study reports and clinical trials can soon change that. To facilitate this, Mitra Biotech is launching formalized studies in India, US and Europe aiming to capture on the clinical utility (do doctors prefer to choose the treatment with highest M-score or their first choice of treatment with high M-score) and patient’s response to these treatments.
Since CANscript technology is validated for thousands of different cancers and supported by clinical correlation studies, it forms a valuable platform for developing anti-cancer drugs in comparison to conventional cell lines or animal studies. Therefore, in collaboration with biopharmaceutical companies, Mitra is actively engaged in anti-cancer drug development. Above all, Mitra continues to explore basic cancer research in the area of tumor microenvironment through their R&D programs.
Kirk shares that Mitra is growing in size and will have job openings in the areas of Clinical testing, R&D, Business development, Sales and Marketing teams. He mentions that they have people with academic as well as industrial experience in the Clinical and R&D teams whereas their commercial team mostly consists of members with prior industrial experience. For open positions at MitraBiotech, you can either visit the company website or their LinkedIn page.
When asked about the company’s culture, Kirk describes it as caring, co-operative and committed to helping patients at a personal level to obtain effective cancer treatments. Mitra Biotech’s contributions towards helping physicians select the best cancer care is a true reflection of the name ‘Mitra’ (derived from Hindi word ‘Mitr’ meaning friend). We thank Kirk Mundy for his time and wish Mitra Biotech resounding success in their endeavor.
About the author:
Riya Binil is a science enthusiast and a creative scientist. She holds an MSc in Applied Chemistry (Cochin University of Science and Technology, Kochi, India), a PhD (National Centre for Biological Sciences, Bangalore, India) and Postdoctoral Research experience (Ottawa Hospital Research Institute, Ottawa, Canada) in Cell Biology. She currently works as a Biotech Analyst with SGS Canada. In addition to science, Riya enjoys music, traveling and experimenting different cuisines. She can be reached at here.
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