COVID has caused a global backlog in cancer care, but CanCertain can speed up treatments, Dr Himanshu Kataria, Founder and CEO, tells Sarah Cartledge
There are a substantial amount of patients globally who have been unable to access cancer diagnosis or care since the start of the pandemic. As clinicians work to make up the backlog, they are being aided by huge advances in science thanks to personalised treatments and precision medicine.
Cancer testing such as that offered by CanCertain will soon deliver results based on drug sensitivity, immunity and drug resistance. Developed by Dr Himanshu Kataria in the north-west of England, a test using 3D cell culture enables drugs to be tested for efficacy on a tumour sample taken via biopsy. By mimicking the natural human body in a laboratory setting, cells grow and act as they do in the body and can be tested for their response to chemotherapy, immunotherapy and targeted therapy drugs.
As cancer is a disease characterised by both a patient’s genetic makeup and that of the cancer cells within their tumour, it generally becomes more heterogeneous as it progresses. As a result, the tumour can include collections of cells with distinct molecular signatures and differential levels of sensitivity to treatment. Despite the development of newer targeted therapies, most cancer patients receive a ‘one-size fits all’ treatment plan because of systematic constraints in cancer treatment.
Targeting the right treatment
Currently, observational trials are running at three UK hospitals in the north-west: Wirral University Teaching Hospitals, Liverpool Heart and Chest Hospital and St Helens and Knowsley Teaching Hospitals. Interim results show CanCertain tests can significantly improve treatment response rates in lung cancer patients. Compared to the standard clinical pathway treatment response rate of 55 per cent, if patients had had a CanCertain test to determine optimal therapy, the response rate would have been 90 per cent.
“CanCertain is not about finding a new cancer treatment; it's about trying to match the cancer patients to the right treatment based on a 3D cell culture of their own cells,” says Dr Kataria who conceived the idea when he was leading research for a clinical research network across 23 NHS organisations. “We are experimenting on the patient, but not the body.”
For patients in an advanced stage of cancer, blood samples are taken to access the tumour cells circulating in the blood. “With our technology we find them in more abundance, so we take those circulating tumour cells and we treat them in 3D with different cancer treatments, which are all approved for that particular cancer, and discover which treatment is more effective.” The CanCertain tests also determine the patient’s immunity and drug resistance, which helps to understand how the tumour will react to a particular drug and whether some cells will be more sensitive than others.
With a turnaround time of just 8 working days, the CanCertain personalised plan helps the patient begin the most effective cancer treatment quickly, thus increasing the chances of early recovery. Currently, it is only available to self-pay patients, but Dr Kataria’s vision is for every cancer patient globally to have the CanCertain test done before they start treatment.
“Currently, 45 per cent of patients will not get a response to their treatment, and they're at risk of side effects. And there is some early evidence that there might be a risk of the cancer worsening,” he says. “CanCertain removes the uncertainty surrounding the effectiveness of the therapy, reducing the need for multiple rounds of different drugs while safeguarding the patient’s immune system. It also reduces debilitating side effects and improves patient quality of life.”
Cutting the cost
Board member Dr Dorai Ramanathan, an oncologist based in Dubai, was one of the early investors in CanCertain. “It is very exciting as you are dealing with a real life situation in a 3D cell culture,” he says. “Instead of giving patients a cocktail of medicines we’ll be giving them the right medication and the chances of a better outcome will be much higher, rather than the current 30-40 per cent. We are waiting for it to become available in the UAE as currently the samples have to be flown back to the UK for analysis.”
The company has a footprint in the UAE and also offices in India where there is considerable interest for different reasons. While cost saving is the main focus, in India the tests will enable more people from all levels of society to access effective care within a tightly controlled budget, and in the UAE it will reduce the number of patients sent abroad for specialised treatment.
By eliminating the number of ineffective drugs that patients take before identifying the best course, the potential to reduce costs is clear. Insurance companies and payors are showing great interest in CanCertain, but more trials are needed before they can agree to include the treatment in their schedules.
“We have spoken to one American insurance company and shown them how they will lose more than $8m just by standing still,” Dr Kataria says. “The cost of a failed first line treatment is around $49,500, so it is in the interests of the payors to have a better shot at success from the start.
“CanCertain is a promising early stage technology, which requires further clinical validation for reimbursement,” he continues. “We are collaborating with the University of Manchester for developing that strong, robust validation. It needs to be proven within the structures, and those structures require a large amount of funding to actually deliver.
“Currently, we are working on the basis that there would be patient recruitment for one year and there would be a fall off of one year. I should be able to deliver results within the span of two and half years to get to a stage where it is available to all patients.”