NEW YORK – Cancer research firm Yemaachi is aggressively pursuing its goal of fostering African genomic research capabilities with the discovery of a new breast cancer-associated BRCA1 variant, the launch of a pediatric cancer research initiative, the continued development of a continent-wide cancer research network, and a residency at the Johnson & Johnson incubator JLABS.
Last week, the Accra, Ghana-based but Delaware-registered company announced the discovery of a new BRCA1 variant at the annual African Organisation for Research and Training in Cancer (AORTIC) conference in Senegal.
That variant, called BRCA1 (p.E1046*), was one of several novel variants found in a whole-exome sequencing pilot study called Brecxome. The company sequenced exomes of 106 Ghanaian women, identifying several known breast cancer-associated variants along with the new one.
Yaw Bediako, founder and CEO of Yemaachi, commented that Brecxome is the first whole-exome sequencing study to take place in Ghana, in contrast to studies wherein samples are collected on the continent but sequenced and analyzed elsewhere.
"It's a landmark achievement," he said. "[First], we did everything in Africa, and [second], with a relatively small number of samples, we found a lot of novel hits."
The new variant was the most significant among these for its potential to be related to cancer. It is currently of unknown significance, but Bediako said that it has the "hallmarks of a driver," in that it shows a high variant allele frequency and is a missense mutation. Although classifying all BRCA1 missense mutations as neutral or pathogenic remains challenging, some have been shown to encourage cancer growth by disrupting the BRCA1 protein's ability to bind to p53.
"It's a novel variant that appears to be germline in origin and to be a significant variant of this particular cancer," he said.
Bediako also said that finding a new variant in such a relatively small study population speaks to Africa's largely untapped potential for expanding our knowledge of genomics.
Genomes of African ancestry represent only a fraction of most genome-wide association studies despite Africa being one of the world's most genetically diverse regions. Additionally, few clinical trials take place on the continent.
"If pharma is thinking about doing trials with existing drugs for existing variants," Bediako said, "Africa is a good place to look because you have large populations of treatment-naïve people, some of whom will have druggable targets."
Another African genomics company, Nigeria-based 54gene, had initiated a project to sequence up to 500,000 genomes across the African continent last year. However, as reported in multiple Africa-focused tech and business publications, 54gene recently began winding down its operations amidst financial difficulties. The company has not announced an official closure but went through three CEOs in the last year and now neither maintains its website nor retains its former public relations agency.
54gene had raised some $45 million across three funding rounds, making it one of the larger African-based and operated genomics firms.
"54gene's demise sucks the wind out of the sails of biotech in Africa," Bediako said, "but we are here and we're growing."
Yemaachi is currently wrapping up the Brecxome pilot study while beginning "phase two" of Brecxome, in which the project is to be scaled up and conducted across borders.
"That is starting now and is going to be longitudinal," Bediako said. "We hope to recruit at least 400 to 500 women in this next phase, but will then continue towards our goal of 1,000."
Yemaachi is now recruiting in Nigeria and Kenya, as well as Ghana, and is awaiting institutional review board approval to begin recruiting in Uganda.
Brecxome is in many ways a continuation of Yemaachi's ongoing efforts to develop local capacity for cancer genomics research throughout Africa. The company has been building a network of cancer research institutes across the continent, bringing partner institutions together under the umbrella of the African Clinical Cancer Research Network, or AfriCaN.
Funded by Yemaachi, the network consists of 23 institutions and is spread across Ghana, Nigeria, Ivory Coast, Uganda, Kenya, South Africa, and Zimbabwe. AfriCaN facilitates clinical cancer research across universities, research institutes, and individual clinicians.
Funds for the network are largely drawn from investor capital and supplemented by grants.
"AfriCaN is basically aggregating all the relationships [Yemaachi] established over the last two years into a community," Bediako said.
The company has signed memorandums of understanding with its AfriCaN partners and has several active research projects in motion, with more starting "soon."
"Beyond the institutions," Bediako said, "we have invited key individuals [such as] oncologists, researchers and patient advocates to join the network, as well. The network is geared towards building community among the individuals and institutions that Yemaachi works with."
Bediako explained that Yemaachi coordinates research between partner institutions and makes its technology and expertise available for projects carried out by the network.
Although the company currently operates as a central hub for AfriCaN, Bediako said that in time, he hopes that more research collaborations will form directly between partnering institutions, without necessarily involving Yemaachi.
"Nothing stops them from interacting directly," he said, "but this doesn't happen as often as you would think," to which he mainly attributed limitations in resources needed for research.
Yemaachi is also focusing on pediatric oncology with an effort launching this month called Project for Pediatric Oncology Research Sites (PROGRESS). Project PROGRESS aims to build a molecular database of pediatric cancers over the next five years by working with hospitals throughout Ghana to collect biological samples and accompanying health data with which to build longitudinal childhood cancer cohorts.
The company has signed on three pediatric oncology treatment centers across Ghana, which whom it has IRB-approved material and data transfer agreements in place.
Bediako said that Project PROGRESS targets the large difference in survival between children in Africa and those in the US and other high-income countries.
The World Health Organization estimates that while approximately 80 percent of children diagnosed with childhood cancers will survive if the disease is detected and treated early, only some 20 percent of children in Ghana and other resource-constrained countries survive.
In 2018, the WHO launched the Global Initiative for Childhood Cancer, aiming to achieve a 60 percent survival rate for children worldwide by 2030 by establishing centers of excellence and care networks in target countries, along with information systems for cancer diagnosis, evaluation, and monitoring. Ghana was among the first 10 "focus countries" selected to pilot the initiative.
Bediako said that efforts such as Project PROGRESS are "very much in line with WHO strategy."
Finally, Bediako said that approximately three months ago, Yemaachi began a virtual residence in JLABS, a life sciences incubator sponsored by Johnson & Johnson. Being affiliated with JLABS, Bediako explained, gives Yemaachi access to logistical support from Johnson & Johnson, mentorship, and numerous opportunities for greater visibility.
"The biggest advantage to us right now is the credibility it affords us," Bediako said.
In addition to its research initiatives, Yemaachi has developed cancer testing kits aimed at reducing obstacles to access, especially in poor and rural areas.
Last year, it rolled out the Sheba-HPV home cervical cancer test in a pilot study taking place in the cities of Accra and Kumasi. Bediako said that the test now also has regulatory approval in Nigeria and Kenya. Yemaachi has been gaining traction in marketing Sheba by partnering with large hospitals, clinics, and nongovernmental organizations, who provide Sheba-HPV to patients as part of their own programs.
"This works for us because our primary focus is research," Bediako said. "We're not really a diagnostic company. Our diagnostic business is very much about impact and not really about profit."
Yemaachi operates its diagnostic business at cost, while bringing in revenue from its research activities and through grants. Bediako commented that the company had applied and been shortlisted for a five-year, $25 million Consortium for Cancer Grand Challenges grant from the US National Cancer Institute. The final funding decision will be made in March.
"There's a long road ahead of us, with lots of pitfalls to avoid," Bediako said, "but I get the sense that morale is high, and we are very excited about the progress we've made."