In November 2016 German-American businessman Cyriac Roeding read a magazine profile of Sam Gambhir, a physician and scientist at the Stanford University School of Medicine. In the article, Gambhir described how he dedicated his career to early detection of cancer only to lose his teenage son Milan to a highly aggressive brain tumor in 2015.
Roeding, the co-founder and former CEO of mobile shopping app Shopkick, was taken aback by Gambhir’s story and immediately emailed him asking to meet. Over the next few months, the pair developed a friendship, and Gambhir became Roeding’s guide to the complex world of biology and engineering.
One day, Gambhir came up with an idea of his own – a poignant one. “Sam asked a simple but profound question,” Roeding recalls. “He said, ‘What if we stopped looking for cancer altogether; what if we don’t watch anymore? What if we forced the cancer to reveal itself instead?'”
Time is of the essence with cancer – the sooner it appears, the longer the patient will live. Early cancer detection has become a key goal in oncology—there are dozens of companies working on liquid biopsy technology that scans blood samples for DNA fragments released by cancer cells. But that was not good enough for Gambhir. His painful personal experience told him that waiting for the cancer to grow enough to be detectable in the bloodstream was too slow and told you nothing about where to find the tumor. “We can’t rely on cancer signals that nature just doesn’t always provide,” he told Roeding. “But if we bioengineer signal, then early tumors can be permanently visible.”
That’s the premise of Earli, which Roeding and Gambhir launched together in June 2018. The California-based startup has already raised $40 million from Andreessen Horowitz, Marc Benioff and Khosla Ventures.
Early’s approach essentially forces the cancer to reveal itself. Bioengineered DNA is injected into the body; when it enters cancer cells, it causes them to produce a synthetic biomarker not normally found in humans — something like limonene, a chemical found in the peel of citrus fruits. If subsequent breath or blood tests find traces of this biomarker, it could be a sign of cancer.
The next step is to find out exactly where the cancer is in the body. The injected compound causes the cancer cells to produce an enzyme, which then absorbs the radioactive tracer, making it visible to the naked eye during the scan. Localizing the cancer makes it treatable—doctors can use precise radiation or targeted surgery to remove it. Earli also plans to use the same approach to target and treat cancer — to kill cells after they’ve been found — though the idea is still in its early stages.
The plan is for Earli to be used at every stage of cancer prevention and treatment: for diagnostic monitoring in high-risk groups such as smokers; for pretreatment to see if the cancer is elsewhere in the body; make it easier for surgeons to localize tumors during treatment; and after treatment to detect any recurrent cancer earlier.
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