While many point to genetic testing as the major breakthrough for personalized cancer treatment, a startup in Virginia thinks that’s only a third of the equation.
“Genes tell you what could be and proteins tell you what is,” Perthera Co-Founder and CEO Dendy Young said. “There’s one more nuance: proteins may be active or inactive, so you really need in effect three different tests to put a picture together of what’s going on.”
Because of this, Perthera focuses on not only genetic testing, but also proteomic testing to come up with personalized cancer treatments for patients. Though it’s useful to know the details of the genes, it’s more useful to know what proteins are in the cell and most useful to know what proteins are active in the cell, Young said. “It’s important to know which pathways are open, which proteins are active–if you use a drug that targets that protein that is active, that’s a much better chance if drug-delivery is effective.”
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The startup claims to be the “only company that safeguards biopsy quality for analysis and takes into account proteomics, genomics and your past medical history.”
Perthera uses this information to create a report for stage-four cancer patients. That report includes the assessment of genes, proteins and clinical history. It’s reviewed by a panel of oncologists who identify clinical trials the patient could join and send it on to the physician and patient.
“We don’t care what’s right for the patient as long as there’s something that’s right for the patient,” Young said. If the patient goes forward with a treatment his insurer doesn’t cover, Perthera sends the insurance company documentation of why the treatment should be reimbursed.
“We can tell a patient there is a right drug for you and it’s XYZ. There is a right drug for you but it’s not yet FDA-approved but it’s in a trial. We can get you into that trial if you want us too.” Or, of course, there is currently no effective treatment for the patient’s cancer. “It’s one (scenario) we hope never to run into.”
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So far, the company has served more than 50 patients, and hopes to reach 100 patients by the year’s end. The goal is to ramp up to being able to serve thousands of patients a month from one location, serving patients all over the world.
“We don’t take a patient away from his home setting, from his home oncologist, from his home, from his house, from whatever–we allow him to stay there,” Young said.
Personalized medicine is a hot buzz phrase right now in healthcare, but personalized cancer treatment is perhaps one of the areas that offer the most obvious and largest benefits. Personalized cancer treatment has potential for huge, life-saving benefits for individuals–finding the right experimental treatment, the right plan of care, the right drug based on the specific make-up of his cancer.
Perthera started out targeting oncologists because they’re the people who dispense chemo drugs, Young said, and though many are interested, they want more data, which the company and others like it are working to provide. Now the company is expanding its scope and marketing to patients as well.
“Because if I had cancer, if I were about to get chemo, I would want to know what chemo they were giving me and whether or not it would work with me,” he said.
Many of the company’s competitors, which include universities and Genomic Health, only do either genomics or genetic testing on a tumor (not proteomic testing). Companies such as Applied Proteomics, which is on the cutting edge of proteomics diagnostics, have seen success–recently closing a $28 million Series C round.
Young said one of the things that sets Perthera apart is its focus on getting the perfect tissue sample. The company gathers tissue in a very specific way–actually having a team in the collection suite–and only uses recently collected tissue samples, or as the company website puts it, “the patient’s tumor today.”
“We’re dealing with current tissue that’s properly handled and properly managed,” Young said. “We can’t rely on a biopsy from three months ago. We feel strongly enough about that we put someone in the operating theater with the patient to collect that sample.”
In time, he said, they may be able to train clinicians at certain hospitals to collect the samples. But until then, Perthera insists on this method because the company is “much more persnickety” than other labs.
While personalized cancer treatment has the attention of many medical experts, oncologists and patients, it struggles for reimbursement dollars. The full Perthera treatment costs under $6,000 out-of-pocket, Young said. (Not astronomical for a medical bill, but certainly making it a hard-to-get option for many.)
“Payers are a conservative lot,” Young said. “Frankly the choice of spending money on multiple rounds of chemo versus spending it just once on the right thing seems to make imminent sense.”
