Sometime in mid-2015, a young cancer patient in New York City was driven to desperation. The family had built a treatment war chest of a few million dollars but the drugs weren’t working. None at all. Not even Keytruda, the expensive breakthrough drug from Merck & Co. which was approved around that time. Through academic connections, the family learnt about Mitra Biotech’s cancer diagnostics technology which the company offered on a compassionate ground. The diagnostic test threw up, to everyone’s surprise, a drug option which was low on everyone’s priority, and also, price.

The $20 chemotherapy drug Topotecan did wonders; the 6 cm tumour vanished.

Two years later, Mallikarjun Sundaram and Pradip Majumder, co-founders of Mitra, cite that case as one of the many ‘good’ surprises in their records as they embark on building regulatory-grade real-world evidence of how their tech works.

In a massive 1600 patient trial, 800 each in India and the United States, Mitra is out to capture in a year the true economic and medical value of its technology. In a complex disease like cancer, drugs are often given in combination. Yet the success rate is abysmal, as low as 20%. The hit-and-miss treatment is avoided in some cancers where there are genetic markers. The patients are then tested for the marker and given the right drugs. However, a new class of drugs called immunotherapy has entered the market—and more than 600 are in development across the world—with an annual cost upwards of $100,000. The hype around most of these encourages rampant off-label use as a last-ditch effort to stall cancer. It’s debatable how much of it is medical advancement and how much leads down a slippery slope because there’s no reliable way of predicting who will benefit and who will not.

Mitra thinks its platform CANScript can. To a great extent, and for the time being, in many types of cancers. So now that its tech can match the patient and the cancer drug up to 90% of the time, the biotech is switching growth tracks.

Deep science & tech companies like Mitra and Strand are capital efficient. Unlike other heavily funded startups which have to give a quick turnaround to their VCs. They may become unicorns, but they are never profitable

Vijay Chandru, Chairman, Strand

Ten years ago, Majumder and Sundaram came from Massachusetts Institute of Technology to Bengaluru to build technology that can be applied globally. Getting clinical samples was easier in India. Now they’ve turned the spotlight back to the Boston area, even flipping the corporate structure. All in preparation for a possible Nasdaq listing. Mitra Biotech is now a brand owned by the US-based parent Mitra RxDx Inc. and Mitra RxDx Pvt Ltd is the fully-owned India subsidiary.

When the US-India patient study completes early 2019, Mitra might be able to do what many modern cancer diagnostics providers have only been aspiring for—reimbursement from payers.

AUTHOR

Seema Singh

Seema has over two decades of experience in journalism. Before starting The Ken, Seema wrote “Myth Breaker: Kiran Mazumdar-Shaw and the Story of Indian Biotech”, published by HarperCollins in May 2016. Prior to that, she was a senior editor and bureau chief for Bangalore with Forbes India, and before that she wrote for Mint. Seema has written for numerous international publications like IEEE-Spectrum, New Scientist, Cell and Newsweek. Seema is a Knight Science Journalism Fellow from the Massachusetts Institute of Technology and a MacArthur Foundation Research Grantee.

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