In India, one woman is diagnosed with breast cancer every four minutes, accounting for 25 to 32 percent of all female cancers across the country. Furthermore, only 60 percent of women who are treated for breast cancer, survive for at least five years post-treatment in India as compared to 89 percent in the US. While these statistics paint a grim picture, a Bengaluru-based startup, OncoStem, is trying to turn things around.

Dr Manjiri Bakre, has a postgraduate doctoral degree in cell biology, OncoStem was built with a vision to develop innovative and affordable tests to personalise cancer treatment.

Dr. Bakres earliest encounter with breast cancer was during her PhD days, when a friend was diagnosed. But since it was diagnosed early, the tumour could be removed. However, soon the cancer relapsed, and spread to multiple organs. It was so sudden; we tried helping by sending her for various therapies, even non-traditional ones, but nothing helped, she says.

The sudden demise of her friend got Dr Bakre thinking about why, despite early detection, so many patients like her friend were unable to survive? When the tumors are small and detected early, typically, such patients should be doing well, she says.

During this time, companies in the West were developing tests that could analyse tumor biology and determine the risk of relapse in patients with early-stage breast cancer. These tests could help personalise a patients treatment plan based on their individual risk of relapse.

However, since these tests were very expensive, Dr. Bakre approached doctors in India and pitched her idea of developing a home-grown and affordable version of a similar test, which eventually led to the birth of OncoStem in 2011.

OncoStems flagship product, CanAssist Breast, is a machine learning-based prognostic test that helps personalise treatment for early-stage breast cancer patients who are hormone receptor-positive (HR+) and HER2-negative. It took 7+ years to develop, validate and get international accreditations for CanAssist Breast before going to market.

CanAssist Breast analyses a patented combination of five biomarkers, digitises historical medical records of patients, feeds into an AI-algorithm and produces a risk score. This score is used to categorise patients based on the risk of cancer recurrence clearly as either 'low or high' with no grey area in between. Patients classified as low-risk can potentially avoid chemotherapy, its costs, and side-effects. CanAssist Breast is performed in OncoStem's NABL and CAP-accredited laboratory in Bangalore. The product is also CE marked.

If the patient is low-risk as per CanAssist Breast, they can avoid chemotherapy and in turn its associated side-effects and financial burden. Chemotherapy can affect multiple different body parts causing nausea, hair loss, infection, anemia, appetite changes, fatigue nerve and muscle problems, urinary bladder and kidney problems, and fertility problems. Febrile neutropenia, a life-threatening complication, is a serious side effect of many forms of chemotherapy.

CanAssist Breast makes customised treatment possible by analysing the patients tumor in depth, and providing a patient specific report indicating if the patient has low or high risk of cancer recurrence. This clear distinction of patients based on risk of cancer recurrence allows doctors to devise chemotherapy treatment in tune with the prognosis, maintaining a balance between the benefits and side effects.

Most tests available in the market that help decide if chemotherapy is required, are from the USA and in turn prohibitively expensive and not validated on Indian patients, Dr Bakre says, adding that CanAssist Breast, launched recently, is the only test validated on Indian patients and is also the most affordable option available currently anywhere in the world at 1/5th the cost of competing tests available in the US.

OncoStem performed a study which is published in Indian Journal of Surgical Oncology, to assess the impact of CanAssist Breast on treatment of early-stage breast cancer patients. In it, they found that CanAssist Breast helped 70 percent of early-stage breast cancer patients avoid chemotherapy. Not only did these patients avoid the physical hardship, but also the financial toxicity of chemotherapy. Moreover, with 93 percent of doctors complying with the test recommendation of avoiding chemotherapy, showed that physician confidence in the test is high.

Since its founding, OncoStem has grown leaps and bounds. Based in Bengaluru, Dr Bakre today has a team of 35 people, including Pathologists, scientists and statisticians, who worked on CanAssist Breast and continue to work on new products and a sales team spread across the country.

However, this upward trajectory had to overcome its share of challenges, particularly when it came to fundraising.

Finding space to set up her laboratory to get the deep science based R&D work going was also a tough task. After months of searching for the ideal space, her investors kindly offered to use part of their office space to set up the laboratory.

Next came the daunting task of working with hospitals and doctors, especially when the company had no track record. Convincing the doctors of the science was the key to get them interested in working with us. I must have approached 50-60 hospitals to work on developing and validating CanAssist Breast, which ultimately led to 10+ large hospitals signing up.

OncoStem's mission is optimising treatment for cancer patients and helping to avoid overtreatment. Dr Bakre says that every member of her team has had interactions with their user base, and has direct knowledge of what information doctors are looking to get from their test, how to improve the user experience, etc. We also are in constant touch with our patients to counsel them, explain the test and follow up on them. OncoStem wants real world evidence of how the test is performing. So they ask patients who took the test if their treatment was as per the test result (i.e no chemotherapy if they were low risk), and also how patients are faring. OncoStem uses this data to publish new clinical utility and decision impact studies.

In the near future, OncoStem plans to expand access to CanAssist Breast to South East Asia & Middle East, while working on the complete automation of CanAssist Breast so that it can be packaged as a Kit in the future. We are also working on developing new tests for two additional cancers and partnering with hospitals across India to clinically validate these tests. We currently have a solution for hormone-positive breast cancer that is already in the market and are working on another subtype of breast cancer as well as ovarian cancer, she concludes.

Read more here:
This diagnostics startup is revolutionising cancer treatment in India - YourStory

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