NEW YORK – Following a $6M Series A funding round earlier this month, Israeli personalized medicine company Curesponse will expand into the UK later this year by establishing a laboratory in London.
The Rehovot-based firm plans to launch clinical trials for its cResponse technology, which uses ex vivo organ culture (EVOC) to model cancer growth and predict a patient's tumor response to chemotherapy and targeted drugs prior to treatment.
Curesponse also plans to use the technology to offer a drug-prediction service for clinicians and drug-development service for pharmaceutical firms in the UK and elsewhere in Europe.
Launched in 2017, Curesponse's core technology stems from drug response research conducted by Ravid Straussman, a senior scientist in the molecular cell biology department at the Weizmann Institute of Science in Rehovot. Straussman founded the firm with Seth Salpeter, the company's chief technology officer, and CEO Guy Neeve.
After receiving an undisclosed amount of seed funding from Israeli life science venture capital firm aMoon in 2017, Curesponse began commercializing a functional cancer drug selection platform based on proprietary collection and analysis methods that Straussman's team developed, which are integrated with EVOCs to prioritize cancer drug treatment.
A clinician interested in using the service would send Curesponse two core tumor biopsies, which Straussman's team slices into multiple tissue sections and places into a proprietary assay culture matrix. Salpeter said that the matrix can preserve the tumor's morphology and architecture within its own microenvironment, while allowing ex vivo cancer growth that mimics what happens in the patient's body.
After culturing the tumor for about five days, the firm then tests 10 to 20 different chemotherapies and targeted drugs to measure their effectiveness on the tumor.
"Our goal is to mirror the patient tissue as it grows in vivo and to disturb it as minimally as possible so that the microenvironment is preserved," Salpeter explained. "Once you're not creating disturbances to the tissue when it's being cultured with the potential drug, you get a much more accurate reading of how the patient is going to respond."
Curesponse will also perform genomic sequencing on part of the patient's tissue to identify tumor-specific genomic alterations, which produces results within 30 hours. Curesponse will then incorporate cancer drugs that it believes can target any identified mutations — as well as drugs a physician is interested in evaluating —to create a panel of potential therapies for the patient.
The cResponse platform then uses a proprietary evaluation system and response algorithm to prioritize treatment options based on demonstrated drug efficacy, which Salpeter said provides results within two weeks.
"Previously, you'd get a genomic report, and it might generally tell you which mutations you might have, [but] there's no way of figuring out which [drug] is more effective," Salpeter said. "We now plan to harness the power of genomics and a basic understanding of what drugs might be effective to input the best options into the cResponse system and chose which are the best for the particular patient."
Curesponse has explored a variety of cancer types to improve the cResponse platform, including colorectal, lung, breast, head and neck, pancreatic, and gastroenterological cancers. The firm is currently researching metastatic GI cancers and neoadjuvant breast cancer with undisclosed Israeli academic and government collaborators.
Curesponse is also partnering with 20 to 30 different Israeli clinicians to test cResponse on about eight cancer indications in clinical trials.
"In Israel, we've been undertaking clinical trials to show how we can get patient biopsies prior to their initiation of treatment," Salpeter said. "We can test samples with whatever treatment the physician tells us that the patient is going to receive, and [thus] we can correlate the prediction to how the patient actually response in the clinic."
Straussman's lab and Curesponse have between them analyzed about 1,000 tumor samples on the cResponse platform.
Curesponse is also working with pharmaceutical companies interested in using cResponse for drug research and development. Salpeter noted that Curesponse has six existing or completed partnerships with undisclosed Israel-based biopharmaceutical firms seeking to improve cancer drug efficacy.
With the completion of the funding round earlier this month, Curesponse now plans to scale both clinically and commercially in the UK and elsewhere in Europe, where it aims to offer drug-discovery services to pharmaceutical firms out of its planned London laboratory.
Curesponse is currently working with British cancer researchers at Hammersmith Hospital, including Jonathan Krell, a senior clinical lecturer in medical oncology at the Imperial College of London (ICL), to continue clinical trials the firm started with Israeli collaborators. While the researchers have applied for approval with ICL's institutional review board for the trials, Salpeter declined to comment on the trial's specific endpoints.
However, he noted that Curesponse chose to expand into the UK because the firm believes London has a "strong clinical system" with a large cancer patient population. Curesponse also envisions the UK as a central hub for servicing the rest of European cancer patient population, as the team believes it can receive samples from other European countries relatively quickly for drug prediction testing.
Curesponse has filed for multiple patents related to the cResponse platform with the US Patent and Trademark Office, as well as with jurisdictions in Europe and Asia.
Alternate drug prediction models
EVOCs are not the only method researchers have used to measure a patient's tumor response to drugs ex vivo. Academic groups have built targeted cancer patient "avatars" using patient-derived xenografts (PDx), where patient tumor cells are implanted into immunocompromised mice and are tested for their drug response.
Researchers have also used a 3D medium to form tumor-based organoids and study cancer drug response.
Swiss startup QGel is commercializing a series of synthetic organoids based on biological, biophysical, and biochemical parameters that researchers can use to mimic organs and tumors to test cancer drugs on cells outside the human body.
When asked as to why customers would select cResponse over other techniques, Salpeter argued that PDx-based models have struggled because they require several months to grow in the mouse and are relatively expensive for clinical applications. In contrast, Salpeter believes that Curesponse can offer a relatively inexpensive model in a shorter period of time that minimizes background errors found in PDx models.
While researchers can use organoid-based methods, Salpeter pointed out that the method commonly involves dissociation of a patient's cancer tissue before it is reformed in a 3D structure.
"As a result, … the cancer is damaged, loses endothelial cells, immune cells, and tissue architecture, which are critical in determining the cancer drug response," Salpeter said. "If the tumor microenvironment is not intact, the in vitro system will likely not mirror the in vivo response."
By using cResponse, he believes clinicians will be able to select drugs with a greater degree of clinical response for their patient and minimize overall costs.
"We will be able to say to patients that 'this drug empirically, on your specific tumor, is going to work best for you … and give you the best chance of increasing overall survival,'" Salpeter noted. "Our goal is to take all the cancer drugs that exist today and figure out how to [apply] them to the patients that are right for them."
While declining to disclose an envisioned price for the cResponse testing service, Salpeter instead hopes that the cost of the service will mirror that of liquid biopsy assays that are currently offered in the clinical space for predicting cancer drug response.
Curesponse envisions that it will complete construction of its London-based lab and begin collecting samples for the international clinical trials by the end of 2020. The group anticipates applying and achieving ISO-15189 status for the lab in 2021, followed by the clinical launch of cResponse by early 2022. After the UK launch of its drug development and prediction service, Curesponse expects to potentially expand into North America.