Raising Awareness of Cancer Screening with C. elegans — Interview with HIROTSU BIO SCIENCE
It’s not only dogs who can sniff cancer - Roundworms have keen sense of smell as well. A Japanese startup utilizes nematodes to detect cancer.
Mr. Takaaki Hirotsu is the CEO of HIROTSU BIO SCIENCE Inc., a health tech startup.
The company provides N-NOSE, a test using C. elegans (a type of nematode) that can determine the risk of cancer throughout the body from just one drop of urine. Compared to conventional cancer screening, it is less expensive, non-invasive, and enables early detection of cancer.
In May 2021, N-NOSE At Home, a service that allows people to take the test at home, was launched in Japan.
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— Please give us a brief description of your business.
We offer a cancer test called N-NOSE, which uses the olfactory senses of a small organism called a C. elegans. N-NOSE was inspired by cancer detection dogs that can smell cancer patients, and I thought that C. elegans, which have an excellent sense of smell, could do the same. The C. elegans reacts differently to the urine of a healthy person and a cancer patient, and this ability is used to distinguish patients from healthy people.
It is quite difficult to detect cancer at an early stage by using existing tests, but C. elegans have excellent sensing ability and can detect even faint odors that cannot be detected by machines. Another advantage of the test is that it is simple and non-invasive, since it can be performed using urine, which is something that naturally leaves the body.
— Will it be able to identify the type of cancer?
Some research suggests that each type of cancer has a slightly different smell. We think that it may be possible to create a C. elegans that reacts only to a specific type of cancer by recombining genes, so we have started research on that.
— Can N-NOSE be utilized in the steps after cancer has been detected?
We are also conducting research on how C. elegans react to the recurrence of cancer after extirpation. For patients who have been physically and mentally damaged by the surgery, it is a huge burden to have to undergo more tests. Doctors tell us it would be wonderful if N-NOSE could be used to check for recurrence.
— Could you tell us about your newly launched service, N-NOSE at home?
When N-NOSE was first put to practical use in January 2020, we envisioned that people would take the test at the expense of hospitals, company health checkups, and health insurance unions, but this soon became difficult due to the spread of COVID-19. So we thought about what we could do, and we set up places in Tokyo and Osaka where people could submit their urine samples for testing. As we wanted the test to be much more accessible, we thought it would be nice if there was a test that could be done without leaving the house. So, we decided to team up with a shipping company that transports pharmaceuticals products. The carrier collects the urine samples at the customer’s home and brings them to our testing center. We started this service in May 2021.
— What kind of approach do you plan to take for business overseas?
Our first priority is the U.S. market, but it is currently at a standstill due to the COVID-19 pandemic. However, even in this situation, we are now considering the possibility of a trial scheme in which urine samples collected in the U.S. would be sent to Japan for testing. Also, in the U.S., we hear that it may be difficult to enter the market without the involvement of insurance companies. I think it would be more convenient for users to provide B2C services as we do in Japan, so we are considering that kind of business model as well. Since there is no primary screening test that can easily be done with urine worldwide, I think there are very few competitors.
In addition, we have informally agreed to conduct a large-scale clinical study in Australia. Most of our samples are still Japanese, so we decided that we need to conduct research on other genetic backgrounds. We have just started working on the protocol with the Queensland University of Technology, and we plan to start by the end of 2021.
— What is the advantage of working with an insurance company in the U.S.?
According to an investigation done by a law firm specializing in FDA (Food and Drug Administration) approvals in the U.S., we were told that N-NOSE would not be covered by the FDA, but by LDT (Laboratory Developed Test). However, the situation surrounding the FDA is changing, and I believe that by working with insurance companies, we will be able to receive information faster and respond more easily to changes in the situation.
— Do you think it is necessary for researchers to have social experience?
I would not say that it is necessary, but I believe that research is closely related to society, and therefore, good research can only be done if you know the social situation.
— What do you think are the similarities between research and business?
Both research and business share the same goal of creating something new. This is especially true for startups. Also, researchers have many opportunities to explain their research in papers and conference presentations, while business managers have to present their business ideas to investors. So there are similarities.
It seems that research and business are generally considered to be two very different things, but when you look closer, I think they have a lot in common.
— There is a lot of excellent research being done, but why is it so difficult for it to lead to practical applications?
There are many researchers who think that research is done independently of society, and the business side often does not understand researchers very well. I believe that practical application will not go well if both sides are isolated from each other.
I think it is necessary to develop human resources who can connect the two.
— What are your expectations for the Plug and Play program?
Our company has a certain level of recognition in Japan, but when we go overseas, we will have to start from scratch again. We think it might be good to have a connection with Plug and Play when we are ready to expand our business internationally. I hope we can build a good relationship in the long run.
It would also be nice if we could look at things from a different perspective and realize that there are various ways of collaboration and procedure.
— Is there anything that you feel is a challenge for the company at the moment?
Some patients feel uneasy because we cannot directly refer them to a medical institution and tell them to take a certain type of test. Since we are currently researching C. elegans that can identify cancer types, we hope to eventually be able to use N-NOSE to identify which cancers have the highest risk, and then suggest that the patient goes to a hospital that specializes in that cancer.
— How would you like to see the environment surrounding cancer testing change in the future?
Every test has its own advantages. If you want to examine the stomach, I think the existing gastroscopy is still the most suitable. I don’t think that our tests can solve everything, so I think it would be great if each test can improve its own specialties. If people find out that they are at high risk by taking the N-NOSE test, even those who have not gone for cancer screening before would think that they should go for it. I hope we can raise their awareness of cancer testing.
(Interviewer: Azusa Katsumi, Editor: Suzu Kitamura)
