A Blood Test That Can Identify Recurrent Cancer

AHA Publisher — Fri, 15 Oct 2021 07:00:04 +0000

Abigail Klein Leichman via Israel21c – When Asaf Zviran was diagnosed with cancer, he was doing operations research and R&D in the Israeli navy and earning his master’s degree at the Technion-Israel Institute of Technology. Maybe that’s why he pictured cancer as an enemy to defeat– if he could find the right weapon and target. After his successful treatment and seven years of military service, in 2012Zviranbegan PhD studies in molecular biology at the Weizmann Institute of Science. During his postdoctoral research at the New York Genome Center from 2016 to 2019, he zeroed in on his target: cancer that persists or returns after treatment. Working with world-class scientists at the center, he invented a whole-genome sequencing method, aided by artificial intelligence, enabling early detection of persistent or recurrent cancer cells from a standard blood sample. As soon as he finished his postdoc fellowship, Zviran and three friends founded C2i Genomics to develop his personalized medicine approach, described in a paper published in Nature Medicine. His postdoctoral mentor, Weill Cornell Medicine oncologist Dan Landau, is the company’s scientific cofounder and sits on its scientific advisory board. The company has raised more than $100 million in financing from Casdin Capital, NFX, Duquesne Family Office, Section 32, iGlobe Partners, Driehaus Capital and others. “With our technology, physicians can monitor their patient treatment response and detect treatment failure or disease recurrence months and even years before they would do otherwise,” Zviran says. Command, Control and Intelligence “C2i is a military term for ‘command, control and intelligence’ – it expresses the vision of applying defense methodologies to oncology,” explains cofounder Boris Oklander, the startup’s CTO. “Cancer is like an enemy with a unique signal of a mutation that we want to detect. We fight this enemy with technology grounded in our experience in the defense sector.” Headquartered in New York with R&D in Haifa and a sequencing lab in Cambridge, Massachusetts, C2i Genomics is one of nine digital healthcare startups in the current cohort of PlayBeyondBio. This is an accelerator run by a partnership of Israeli venture capital fund JVP, British-Swedish pharma giant AstraZeneca, international consulting firm Accenture, Margalit Startup City, Amazon AWS, and Shaare Zedek Medical Center in Jerusalem. “The idea is to see how this ecosystem of partners can join forces and generate pilot studies,” says Oklander. “There are biobanks of patient samples in Shaare Zedek that can help evaluate and validate technologies like ours and help get our plug-and-play diagnostic service to market quickly.” In July, C2i signed a collaboration agreement with Premier, an American healthcare improvement company. The agreement includes implementing the C2i platform at eight Premier member hospitals and clinics. Ending Over- and Undertreatment Oklander tells ISRAEL21c that this unique approach could solve the significant problem of over- or undertreatment of solid tumors. What usually happens is that the tumor is removed surgically. The pathology report helps the oncologist make an educated guess whether to wait and monitor the patient periodically, or to start chemotherapy and/or radiation as a precaution against undetected cancer cells. “There is no good way to know in real time if the patient is cancer-free,” says Oklander. Patients getting chemotherapy need to wait months before knowing if there is a good response. Patients getting monitored may have a tumor growing undetected during that time. “If we can measure the level of cancer in the patient’s blood in real time — like measuring the glucose level in diabetics — there is no need to predict but rather measure what is happening right now and support clinical decision-making relating to which treatment to use, or to monitor and step in as soon as necessary.” With 20 million new cancer diagnoses around the world each year, this method could save many people from being overtreated with toxic, painful, costly chemotherapy and from being undertreated while a new tumor is quietly growing. “Our test can improve the entire cycle for the patient and for the payers,” says Oklander, noting that insurance carriers are shifting their focus to evidence-based reimbursement to improve the economics of oncology. World First Although other cancer genomics services are available, C2i’s platform is designed to be uniquely accessible and thorough. “The way our competitors work is that patient blood samples are sent to a central lab, usually in the United States,” says Oklander. “Our distributed solution is logistically simpler because the sample can be processed at any genomic sequencing lab. There are 15,000 sequencers in the world — the machines that produce genomic data from blood samples. Each of these sequencers can communicate with us through a secure Internet connection.” Compliance with GDPR (Europe) and HIPAA (USA) privacy regulations is configured into the C2i system for each region, he adds. The other difference is that C2iscans the entire genome to find thousands, or hundreds of thousands, of mutations unique to each patient. “In two people with the same cancer diagnosis, less than 1% of the mutations are common between the two of them,” explains Oklander. “We capture the entire genomic makeup of each patient using AI and signal processing. Then we test the blood at all stages in the treatment to see if these mutations are still present.” Zviran notes that C2i Genomics was a finalist for the 2021 Spinoff Prize awarded by Nature and Merck. “We are proud of the recognition of our work detecting ultra-low amounts of tumor DNA in blood samples, to guide treatment decisions and ultimately save patient lives,” Zviran says. For more information, click here To read the original article click here.

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Immunotherapy Combo Halts Rare, Stage 4 Sarcoma in Teen

AHA Publisher — Mon, 19 Oct 2020 07:00:20 +0000

Hackensack Meridian Health via EurekAlert – October 15, 2020 – Nutley, NJ – A patient with end-stage and rapidly progressing soft-tissue cancer whose tumor did not respond to standard treatment, had a “rapid and complete response” to a novel combination of immunotherapy, according to new research published by a team of scientists from John Theurer Cancer Center at Hackensack University Medical Center and the Georgetown Lombardi Comprehensive Cancer Center, both of whom are part of the Georgetown Lombardi Comprehensive Cancer Center Consortium. The immunotherapies targeting the immune checkpoints T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1) were administered to a 19-year-old patient with stage 4 epithelioid sarcoma. The patient, whose tumor responded within two weeks after receiving the combination, resumed normal activity and was in a complete remission at the time of the report. The single case was reported online August 18, 2020 in the Journal of Immunotherapy (with the patient’s consent). “Epithelioid sarcoma is a rare cancer, and the outcome was not expected to be so positive,” said Andrew Pecora, M.D., F.A.C.P., C.P.E., the division chief of skin cancer and sarcoma services at John Theurer Cancer Center. “The breakthrough in this patient’s care was the result of the close collaboration between clinician scientist of the Consortium to elucidate the underlying mechanisms that suggested potential sensitivity to the checkpoint inhibitors. “The teamwork in this case, which involved experts from our Consortium, turned things around for this patient,” said Louis M. Weiner, M.D., director, Georgetown Lombardi Comprehensive Cancer Center and the MedStar Georgetown Cancer Institute. “The team will follow the patient closely in hopes that we can continue to keep the cancer at bay.” The patient was first diagnosed with the soft-tissue sarcoma along the spine in 2017, as a 17 year old. Chemotherapy, radiation and standard of care drugs, were administered, and surgery was performed to achieve partial response. The patient was admitted to the hospital in April 2019 in severe pain and his cancer had progressed to stage 4. Most cases of epithelioid sarcoma show an inactivation of a protein-coding gene known as SMARCB1. That inactivation leads to the suppression of INI1, a gene that codes for a tumor-suppressing protein, effectively causing a biological chain reaction that promotes tumor growth. The doctors at John Theurer Cancer Center, working as a team with Georgetown’s experts, obtained a compassionate use authorization to try two checkpoint inhibitors, ipilimumab (anti-CTLA4) and nivolumab (anti-PD1) in May 2019. By October, the patient was in complete remission. As of his last visit in June 2020, he has resumed normal activities and normal physical examination and is essentially asymptomatic. According to the report, the patient’s tumor was reliant on the lack of INI1. But the checkpoint inhibitors apparently unmasked the immune system, making the cancer cells susceptible to the body’s natural defenses again. The researchers write that more about the dramatic reversal of the patient’s cancer needs to be further investigated, particularly what effect the chemotherapy before and after the checkpoint inhibitors may have had. “Immune checkpoint inhibitors are finding a way to effect previously impossible outcomes and we are trying to learn about the precise indicators that suggest clinical utility of the checkpoint inhibitors,” said senior author Jeffrey Toretsky, M.D., a professor of oncology and pediatrics at Georgetown Lombardi and chief of MedStar Georgetown University Hospital’s Division of Pediatric Hematology/Oncology. “This patient opens a window for this exploration. We’re proud to be able to successfully treat patients in this way.” “We are eager to see what our science can do for our sickest patients,” said Andre Goy, M.D., M.S., physician-in-chief of Oncology, Hackensack Meridian Health. “It seems like almost anything is becoming possible.” To read the original article click here.

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A Blood Test That Can Identify Recurrent Cancer

Immunotherapy Combo Halts Rare, Stage 4 Sarcoma in Teen