Startup to offer 100,000 free cancer tumour sequences

Strata Oncology, a start-up company, wants to test 100,000 cancer patients in the hope to identify rare DNA faults so that they can be directed to the best pharmaceutical company for treatment. The test would probe the DNA of tumour tissue by searching for mutations in hundreds of genes. Similar tests are already offered, but Strata's unorthodox business plan hopes to eliminate the issue of DNA testing cancer cells as an experimental procedure, where insurers will refuse to pay out for patients for this reason.

Similar tests are already offered commercially to doctors by several companies, including Foundation Medicine of Cambridge, Massachusetts, and can cost $5,000 each.

Strata’s unusual business plan of giving the tests away arose as a way to solve a cancer Catch-22. Because DNA sequencing tests are considered experimental by insurers, they don’t always pay for them. But without such data, drug companies are having difficulty locating patients for trials of new precision drugs that target specific DNA mutations.

“The purpose of the company is to dramatically accelerate enrollment into clinical trials by removing sequencing as a barrier,” says Dan Rhodes, Strata’s CEO and formerly an executive at Thermo Fisher, which sells sequencing equipment and is supplying the startup with machines.

The company arose out of a National Cancer Institute study, called the Match trial, which since last year has been offering free biopsies and DNA tests to patients around the U.S. It then assigns patients to receive one of 20 targeted medicines based on their tumor’s DNA, whether they have skin, lung, or brain cancer.

“What we are trying to find out is [what happens] if you ignore the disease and just focus on the mutation,” says Robert Comis, co-chair of the ECOG-ACRIN Cancer Research Group, the Philadelphia research organization that administers the Match study.

The Match study is free to join: the government covers both the cost of the tests and of biopsies, which can run another $15,000. Companies provide the drugs. Response to the study was so great that doctors had to put it on pause.

There’s anecdotal evidence that the development of precision drugs is being slowed by the lack of routine DNA tests. GlaxoSmithKline says it had to test 11,000 patients to locate just 23 it needed for a study of a lung cancer drug. That drug targeted a particular DNA mutation which appears in only 1 to 2 percent of patients. The company predicted that a large Phase III study would take 14 years to find enough patients.

“We need to boil the ocean, find the genetic populations, and get them on the trials,” says Keith Flaherty, an oncologist at Massachusetts General Hospital who helped lead the Match study and is also a founder of Strata.