Cancer survivors could have tumor cells circulating in their blood stream and not know it, because imaging exams don’t detect these indicators of potential malignancies, says Mara Aspinall, the chief executive of On-Q-ity.
On-Q-ity, a diagnostics startup based in Waltham, MA, wants to find these circulating tumor cells in patients’ blood and use biomarkers to shed more light on their cancer. The company formed in 2009 through the merger of Silicon Valley’s Cellective Dx and The DNA Repair Company in the Boston area. Aspinall led On-Q-ity’s efforts to raise $26 million in a Series A round of venture capital last year. She is a big name in the diagnostics world, given her previous role as president of the genetic testing unit of Cambridge, MA-based biotech giant Genzyme (NASDAQ:GENZ), and she’s moved her new company into the center of the discussion about the future role of molecular diagnostics in cancer treatment.
Aspinall says that one area of opportunity for her company is in tracking breast cancer relapses (yet she sees applications of the technology at multiple stages of cancer treatment and for many different types of tumors.) Breast cancer is the most common cancer among American women after skin cancer, according to the National Institutes of Health. A lurking danger for these women, after they complete treatments to wipe out their breast cancer, is that the gold standard imaging exams like MRIs and CT scans only catch tumors of a certain size. That means some percentage of recurring tumors go unnoticed, Aspinall says.
She compared this chilling scenario to a black hole in outer space.
“The patient is told that we don’t see anything abnormal. We see no lumps. We see no re-growth,” Aspinall says. “But the reality is, and this is what we call the Diagnostic Black Hole, is these patients are being told that they are in remission, but they may not be. The tumor is just too small to be seen.”
While On-Q-ity’s technology is still in development, it’s not tough to imagine how the company could address this problem in breast tumor detection and other cancers. It’s working on a microfluidic chip the size of a microscope plate. A blood sample would flow through the chip, in which thousands of antibodies attached to microscopic posts would capture the tumor cells. The tumor cells from the patient’s blood could then be analyzed and counted, Aspinall says. The CEO envisions the firm’s microfluidic chips being used as the foundation for capturing molecules in the blood for many types of diagnostic tests. Yet cancer is the primary focus of her firm at the moment.
The startup is developing its own biomarkers that indicate whether the cancer has resistance against certain cancer treatments such as chemotherapy. Such biomarkers could be used to help guide decisions about which cancer treatments to use on patients. The biomarkers might also enable doctors to monitor changes in tumors during treatment to show, say, whether the tumor is building resistance to a particular therapy.
The company faces some stiff competition in the market for technology to gather circulating tumor cells. Veridex, a unit of the health products giant Johnson & Johnson (NYSE:JNJ), is already marketing a kit with antibodies and chips for collecting tumor cells in the blood. Quest Diagnostics, one of the largest operators of diagnostics labs in the world, has adopted the Veridex system, according to its website.
But On-Q-ity aims to improve not only the accuracy of tumor cell counts but also the ability to analyze them. “First generation [circulating tumor cell] technology is limited in practice to just enumeration of cells, and it suffers from both poor sensitivity and specificity,” said Bruce Booth, a partner at Atlas Venture in Waltham, and a board member at On-Q-ity, in an e-mail. “On-Q-ity’s next generation platform offers not only better enumeration metrics, but also opens up the opportunity to characterize [circulating tumor cells] at a genomic and proteomic level.”
On-Q-ity owes its technology to its Silicon Valley and Boston roots. The merged company got its microfluidic chip technology for capturing tumor cells from Mountain View, CA-based Cellective, where Aspinall had been CEO between her leaving Genzyme in 2008 and the merger with The DNA Repair Company last year. (Cellective closed its Silicon Valley office and move its operations to Waltham last year.) Mehmet Toner, an engineer at Massachusetts General Hospital in Boston, is one of the inventors of the microfluidic chip. (Toner also invented the core technology at Cambridge, MA-based Daktari Diagnostics.)
The DNA Repair Company, which Xconomy profiled back in December 2007, brought On-Q-ity expertise in biomarkers that might be used to predict tumor resistance to certain cancer treatments. On-Q-ity is in the process of testing those biomarkers to determine whether they could be used to help guide doctors in treating breast and lung cancers, Aspinall says. The biomarker know-how came from the labs of Alan D’Andrea of the Dana-Farber Cancer Institute in Boston and Michael Yaffe at MIT.
Investors have now bet more than $50 million on On-Q-ity’s technology. Cellective and DNA Repair raised a combined sum of about $30 million prior to their 2009 merger, and then On-Q-ity raised $26 million in first-round financing from Atlas Venture, Bessemer Venture Partners, Mohr Davidow Ventures, Northgate Capital, and Physic Ventures last year. Mohr Davidow was a previous investor in both Cellective and DNA Repair.
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