An unheralded Silicon Valley biotechnology startup – not Theranos, not 23andMe – is fundamentally changing the rules of cancer screening. CellMax Life, headquartered in both Mountain View and Taipei, is deploying a technology that can detect cancer cells at their earliest stages. It has the potential to decisively change the economics of cancer screening and impacting cancer outcomes worldwide.
CellMax’ first product, a colorectal cancer screening and monitor test, is already being used for screening people as young as 30 years of age in Taiwan. Colorectal cancer is the number one cancer there, currently growing unchecked year after year. Every 35 minutes, a Taiwanese is diagnosed with it.
The impact of CellMax’ early detection should be substantial – not only in screening and diagnosing cancer but also because it makes it possible to treat colorectal cancer at a cost far less than it costs when it is diagnosed late-stage. That is currently when the majority of diagnosis happens in Taiwan.
Our understanding of cancer and what causes it is far greater than it ever has been and yet still woefully insufficient to meaningfully impact health outcomes. It is undisputed that early detection has always had, and still has, the greatest impact on cancer survival rates, says Dr. Manana Kvezereli Javey, medical director for CellMax Life. Treatment at the early stage is substantially more effective and the chance of remission far higher, she explains.
That early screening leads to early detection has already been shown in a study by the American Cancer Society. Researchers used the National Cancer Data Base, a hospital-based cancer registry that covers nearly three-quarters of all cancer cases in the United States. They found that under the provisions of the Affordable Care Act, the expansion of insurance among younger women has made it possible for more of them to get early screening. As a result 79% of women age 21 to 26 who learn they have cancer received an early stage diagnosis in 2011-12, up from about 71% in 2007-09.
Still, early screening continues to be the subject of major debate. Advocates insist it saves lives and is far more effective in reducing cancer fatalities than if the disease is detected in later stages. Critics of early screening argue that imprecise procedures often lead to unnecessary surgery or radiation, leading to other complications and raising treatment costs. But generally speaking, cancer patients seem to want to know about their disease as early as possible, so they can make their own decision about how to proceed.
Not surprisingly, most experts on both sides of the early-screening argument agree that the ideal is to make cancer screening simple, convenient, and accurate enough to be widely deployed and done regularly. This will reduce the need for expensive and still mostly ineffective chemotherapy while having the largest possible impact on cancer mortality.
The key with CellMax isn’t simply its ability to detect cancer early, which is hugely challenging on its own, but also be able to do it with a one-minute, simple, routine blood test.
CellMax’s technology identifies and isolates so-called circulating tumor cells (CTCs). CTCs are shed into the blood stream very early even by the most minuscule tumors, well before they can be picked up by normal imaging screening methods. And though CTCs have been studied for almost two decades, researchers have not been able to find them consistently enough in the early stages of cancer to make them clinically useful for early-detection.
CTCs often get lost in the plethora of blood cells, so it’s finding the proverbial needle in the haystack. While conventional screening procedures are unable to identify cancer cells until there is a large enough tumor mass to detect, CellMax is capable of signal their existence at the very earliest stages. All with a simple blood test that has been validated in clinical studies.
The colorectal cancer blood test is only the first CellMax product. It plans soon to introduce similar screening tools for prostate cancer, breast cancer and other hard-to-detect types. It has an ambitious long term vision of providing all cancer-risk, screening and disease-related information for both healthy and diseased patients.
In June 2015, the American Society of Clinical Oncology (ASCO) published a proposed framework for assessing the value of various cancer treatments. The goal was to evaluate treatment regimens on the basis of their clinical benefit, toxicity and cost. It’s quite possible that this assessment could validate CellMax and its methods.
While the cost of cancer care accounts for a relatively small portion of overall U.S. health care expenditures – it still is expected to rise to $158 billion in 2020 from $125 billion in 2015. And its social and emotional costs are incalculable. It would be a big deal if we gained the ability to mass screen, detect early and dramatically reduce the cost of effective treatment.