A technology platform that uses data analytics allows Mitra Biotech to find the most effective cancer drug for specific patients in seven days--exponentially faster than traditional methods.

Ask any child what the largest mammal in the world is and you'll probably be told it's the blue whale. Measuring 30 meters and weighing over 170 tons, the size, however, isn't the only thing that makes blue whales special.

It is also more likely, given its size, to get cancer compared to any other mammal. In the words of author Carl Zimmer, "Strictly speaking, there should be no blue whales." And yet, they live.  

In fact, blue whales can live for over a century. The longest living blue whale has flipped its large fins for 114 years. Scientists believe that they possess a natural mechanism that suppresses cancer that's a 1,000 times effective than humans.

Humans can be affected by over 100 types of cancer. According to the World Health Organization, cancer causes close to 500,000 deaths in India every year, and by 2017, that number will rise to 700,000. High treatment costs is one of the big challenges to beating cancer. Slow, inaccurate treatment is another. Here's the dark truth about cancer treatment: Choosing the right treatment involves some amount of guesswork. While selecting which type of chemotherapy to use, doctors rely heavily on experience and information available from historical data. Despite advances in science, finding the right drug is often a matter of trial-and-error.

One company plans on changing that.

Early Symptoms

 Founded in 2009 by three Indian scientists, Dr. Mallik Sundaram, Dr. Pradip Majumder, and Dr. Shiladitya Sengupta, Mitra Biotech is a personalized cancer biology company headquartered in India. Mitra Biotech has gotten media attention thanks to its technology that offers a way to drastically reduce the guesswork around cancer medication--and speed up the process of figuring out the right medicine. It's on Fast Company's list of the 10 most innovative companies, "for rethinking conventional cancer drug therapies by applying data analytics."

Before they launched Mitra Biotech, the three scientists ran a company in the US known as Mitra Life Sciences. Among his other accomplishments, Dr. Sundaram, an alumni of IIT-Varanasi, taught at MIT, Cambridge, MA, training students in the area of complex analytics and cancer biology. He also co-founded Momenta Pharmaceuticals and developed an FDA-approved, generic drug known as M-Enoxaparin. In 2010, the first year of approval, M-Enoxaparin brought 60 percent of the $4.5 billion global sales to Momenta and its partner Novartis.

Dr. Majumder developed and steered two anti-cancer drugs from laboratory to Phase 2 of clinical trials in the US. He was also a professor of oncology at Harvard Medical School.  And Dr. Sengupta is an assistant professor at Brigham and Women's hospital at Harvard University. In addition to Mitra, he has co-founded Cerulean Pharma (US), Vyome Biosciences (India) and Invictus Oncology (India).

 In 2009, they decided to shift base to India because they saw the scope to help a larger pool of cancer patients.  

Technology Therapy

Traditionally, there are a couple of methods doctors use to select a cancer drug.

 One uses bio-markers to track the effects of cancer treatment. Biomarkers can be specific cells, molecules, or genes, gene products, enzymes, or hormones which can determine which cancer drug isn't effective--but it can't tell which drug works for a specific patient.  

Another method, the Xenograft mouse model, transplants cancer cells from humans into mice. Mice are then dosed with different drugs, until the right one is found. It's a slow method though. According to Dr. Majumder, it can take four to six months for cancer cells to grow inside a mouse, which delays the drug selection process.

For different reasons, neither of these methods are as effective as people hope. The founders of Mitra Biotech knew this, and worked on a solution to the problem. That solution is called the CANScriptTM model.

The CANScriptTM model is a platform that hosts cancer tumors in its native form in a specially customized incubator and provides a micro-environment where different drugs can be tried on cancer tumors. The CANScriptTM model shrinks the time it takes to select the most appropriate drug from months to just seven days.

Part of the reason the CANScriptTM model can do that is thanks to its robust analytical framework. CANScriptTM results are expressed in a predictive measure called the "M-Score". The CANScriptTM model measures the effect of multiple drugs on a patient's tumor using as many as 17 different parameters to assess the key effects on cell viability, cell death, tumor morphology, and cell proliferation. The raw data from these assays are converted into numerical scores that range from 0-100. Mitra's proprietary algorithm then assigns appropriate weightages to individual assays and then converts them to a single, numerical, predictive score called M-Score. The higher the M-Score, the greater the probability that a given drug combination works for a specific patient.

 The M-Score algorithm was developed by simultaneously measuring patients' clinical responses to given drug combinations as well as CANScriptTM measurements across multiple dimension (17 assays measuring the tumor's response to drugs).

Advanced bio-informatic tools were used to assign differential weightages and arrive at a unique algorithm with the least cumulative penalty when comparing the prediction to actual clinical outcome in 1,000 patients in the training set. This was further confirmed in a separate set of 1,000 patients in the test cohort. Cumulatively, CANScriptTM has a very high sensitivity and specificity for different class of drugs-chemotherapeutics, biologicals, and targeted drugs. Data analytics is the key to the spectacular success of CANScriptTM model.

"The accuracy level of the analytical system is extremely high, ranging between 90 and 95 percent," says Dr. Sundaram.

 Rx Accuracy

The CANScriptTM model, with its data analytics framework, doesn't only provide faster results than traditional models, it can also ensure more accurate results.  

 Dr. Sundaram cites the example of a 57 year-old male suffering from head and neck cancer. The patient's first line of treatment with Cisplatin, Docetaxel and 5-FU (CDF) failed. CDF is the most often prescribed drug for first line of treatment.

They performed CANScriptTM analysis on his tissues with a list of drug combinations recommended by his physician. One of the drugs in the list was a combination of Cetuximab+Cisplatin+5-FU--usually not recommended during the initial stages of treatment.  "But as it turned out, CANScriptTM helped us identify the right drug and it was effective in ensuring a complete response from the patient," says Dr. Sundaram.

 This exercise of eliminating trial-and-error not only avoids delay in delivering the right treatment but also saves the patient unnecessary toxicity and side effects. It also has huge cost benefits. "There are lots of other patients with solid as well as hematological cancers who have benefitted from our technology," says Dr. Majumder.

There are other types of cancers that Mitra Biotech is helping patients with. HER2+ cancer, for instance, is a type of breast cancer. Herceptin is one of the drugs recommended to HER2+ patients and can cost lakhs in treatment in India. The drug, however, may not be effective on all patients suffering from HER2+ type breast cancer, and could result in patients spending enormous amounts of money. "Only 35-40 percent of the patients respond to the treatment," says Dr. Sundaram.

 Mitra Biotech is partnering with leading Indian and American cancer hospitals such as Tata Memorial Hospital, Mazumdar-Shaw Cancer Centre, HCG Cancer Care Network, and Cancer Treatment Centers of America.  Last year in October, Mitra Biotech raised funding of about Rs 40 crore from Tata Capital Innovations Fund, along with existing investors such as India Innovation Fund and Accel Partners.

"We wish to ease the treatment cycle for patients and support their fight against cancer by helping them choose the appropriate drug," says Dr. Sundaram.

Going forward, the company hopes to optimize its technology platform and strengthen the process of drug discovery and help cancer patients find the perfect drug.

We'll probably never have the blue whale's ability to resist cancer, but with CANScriptTM, it may be possible to address cancer faster.   

Shubhra Rishi is senior correspondent. Send feedback on this feature to [email protected]