Kanteron Systems Pivots to Clinical Genomics

That is just one of several reasons why the company is in an evolutionary phase right now. Notably, last July it moved into new headquarters in Paterna, Spain, in a technology center outside Valencia called Parque Científico. Kanteron said on its website that the move was due to its "need to be closer to researchers, genomic labs, and the vibrant Valencian biotech cluster."

The business model also has been evolving to meet new demands.

"Our customers two years ago did not want to hear about the cloud. Now everybody wants to hear about the cloud," Kanteron Founder and CEO Jorge Cortell told GenomeWeb this month at the annual Healthcare Information and Management Systems Society (HIMSS) conference in Orlando, Florida. The cloud, he noted, offers superior scalability, reliability, and security to on-premises implementations.

Customers used to see Kanteron's technology as a capital expense rather than an operational expense, according to Cortell. That has flipped in the last two years. Customers now pay monthly subscription fees for training, implementation, tech support, and constant updates to Kanteron content, rather than paying by the project.

During his keynote address to open the 2018 HIMSS conference, former Google CEO Eric Schmidt gave Kanteron a plug, noting that the Spanish company supports telegenomics via the Google Cloud. Kanteron also works with the other two major cloud service providers, namely Amazon Web Services and Microsoft, and has partnerships with IBM and Hitachi.

In genomics, Kanteron provides sequencing quality assurance, integrates genomic data into clinical information systems, supports genome annotation and variant filtering, and integrates with electronic case form reporting for clinical trials. Additionally, the company makes a pharmacogenomics module that connects to electronic health records and picture archiving and communication systems (PACS).

With the cloud infrastructure, updates to the open-source Kanteron platform are very regular as developers incorporate new medical knowledge and aggregated patient test results. "We're updating almost on a daily basis," Cortell said.

Along with its computational biology platform — including annotation tools — the company provides pipelines for medical imaging, digital pathology, and genomics to support clinical care.

While Kanteron has built its own pipeline in the short time it has been in genomics, it also culls from more than 100 external databases worldwide.

Kanteron started in imaging, focusing exclusively on creating pipelines and computational technology for PACS for the first six to seven years of its existence. The company made a logical expansion into digital pathology early this decade.

Then Cortell moved to New York to open up a US subsidiary to set the stage for expansion. There, he met a woman and got married. His wife soon was diagnosed with breast cancer.

After treatments stopped working, a potential customer allowed Cortell to observe a tumor board discussing his wife's case.

"It shocked me because I saw the surgeon, the oncologist, the pathologist, and the radiologist arguing about things that seemed to me like it should be either white or black," Cortell recalled.

While the board was trying to figure out why a medication was not working or whether the patient's breast cancer had returned or if the tumor had metastasized, Cortell was struck by the fact that the medical professionals were reading from paper test reports and measuring and marking up printed images with rulers and pens. Her tumor had been sequenced, but otherwise, the medical team was working with 20th century technology.

"Coming from radiology, everything is digital, everything connects," Cortell said. Upon seeing how this tumor board was not working digitally, Cortell asked the physicians, who were affiliated with Memorial Sloan Kettering Cancer Center and Mount Sinai Health System, to list all of their challenges for them.

"I'm like, 'OK, I'm going to go back to my developers and I'm going to tell them stop everything we're doing,'" Cortell said. "We're going to focus on this to tackle all of these things."

So Kanteron just stopped in midstream and pivoted into clinical genomics.

"It was an irrational, nonbusiness decision," Cortell admitted. But he was confident that the two institutions would find a suitable clinical genomics use for Kanteron's technology.

"They knew what they were doing and they knew exactly why that was not digital. They knew the challenges," Cortell said. "They just couldn't find a vendor that could solve that."

Knowing that this move was "outside the box," as Cortell put it, he decided that meeting the challenge required looking equally far outside Kanteron's traditional market. The company hired an R&D specialist from the European Space Agency, a video game developer, and an expert on robotic vision.

"We went back and reviewed the case, and sure enough, it was very clear. It was a recurrence and the reason why the medication was not working was a variant in the patient," Cortell said. "It was obvious once you got the data in front of you."

Cortell said that his wife is now cancer-free.

"Then I realized, we have something that seems unique, but first I'm going to validate that it is because maybe everybody and their mother has it and they just didn't know it," said Cortell, who did not know the clinical IT industry at all when Kanteron moved into genomics.

At the 2016 HIMSS conference, Cortell made the rounds of the massive exhibit hall, talking to executives of medical imaging companies. None had anything like what Kanteron had developed, and none seemed to have plans to build anything similar.

For the next year, he traveled to some 60 countries to meet with ministers of health and with experts at teaching hospitals. "I wanted to learn two things: A, that it was really useful and applicable to more cases; and B, if there was any demand," Cortell said

He found that it was useful and that demand was worldwide. "So I built a huge pipeline by myself," Cortell said.

After Cortell's exhausting exercise in globetrotting and a total of two years of exploring this change in direction and validating the technology, Kanteron brought its clinical genomics platform to market a year ago. The company does not disclose all of its customers, but said this month that it has landed a contract with the University of Cambridge's computational biology lab and Zetta Genomics, which together serve Genomics England, the International Cancer Genome Consortium, and the European Bioinformatics Institute.

To date, all the growth has been organic, and Cortell remains the owner, but he knows he is going to have to cede control soon to meet demand in this fast-growing clinical genomics market.

Cortell has been actively courting major companies to buy Kanteron. In September, Kanteron sent Agfa-Gevaert a nonbinding "indication of interest" to be acquired. However, Agfa subsequently said that it was not interested.

Cortell said that discussions are continuing with other, unspecified potential takeover partners.