Peter Cheng, CEO, Endofotonics
Gastric cancer remains a crucial cause of cancer deaths worldwide with a high mortality rate owing to the fact that the majority of gastric cancer cases are diagnosed at an advanced stage when the prognosis is inadequate, and the treatment options are circumscribed. Unfortunately, the prevailing circulating biomarkers for gastric cancer diagnosis and prognosis display low sensitivity and specificity. Besides, the gastric cancer diagnosis is based only on invasive procedures such as upper digestive endoscopy. There is a significant need for less invasive or non-invasive tests, along with highly specific biomarkers in the case of gastric cancer. Even though gastric cancer has shown a decreasing incidence in the last decades, the survival rate continues to remain poor primarily because most patients are asymptomatic until the disease progresses to advanced stages. This is precisely what Endofotonics intends to change.
On a mission to provide real-time early gastrointestinal cancer diagnosis, Endofotonics has emerged as a gamechanger in reducing cancer burden through earlier diagnosis. Established in 2013, Endofotonics is a spin-off by two founders from the National University of Singapore and the National University Hospital of Singapore. The company is pioneering the development of an AI-enabled platform for in-vivo real-time cancer diagnosis and improving timely medical interventions. Endofotonics is also on-route to release a medical device to support endoscopists in a diagnosis of early gastric cancer. “Starting with a skeleton team of 3, we are now 12 men strong, and believing that early diagnosis of cancer can deliver better prognosis to patients,” asserts Peter Cheng, CEO of Endofotonics. Peter draws on his years of experience in product research and development, as well as product commercialization across diverse industries, to lead his team at Endofotonics against the second leading cause of cancer mortality in Asia: gastric cancer.
In 2016, ZIG Ventures and Seed’s Capital invested $4.5 million in Endofotonics, boosting the company to industrialize and productize its solution. Three years later, the first minimum viable product called SPECTRA IMDxTM was developed, along with it, the clinical trial also commenced. The very next year, Endofotonics managed to raise its second round of funding of $12 million, and this investment hugely supported the company to pursue regulatory certification and commercialization journey.
During a white-light endoscopy examination of the stomach, clinicians would distinguish suspicious areas through differences in color and surface changes. Under normal whitelight endoscopy, it relys on endoscopist to sysball the lesions.
Starting with a skeleton team of 3, we are now 12 man strong, and believing that early diagnosis of cancer can deliver better prognosis to patients
When using enhanced endoscopic imaging, lesions can be differentiated but it take more time and training and experience in order to use it effectively. Still, the specificity and sensitivity of obtaining a positive biopsy are low. With SPECTRA IMDxTM, when a clinician is suspecting a lesion, he uses the IMDx Raman probe to contact the suspicious lesion to obtain real-time feedback if the tissue in question is of a high risk of early gastric cancer. At the same time, clinicians can obtain better yield in their biopsies and also gets the opportunity to decide in-situ what course of actions can be undertaken. As the solution leverages Raman Spectroscopy to identify the molecular makeup of the tissue, it interrogates with low-powered near-infrared laser. The resulting Raman spectrum emitted from the molecular bonds within the Peter Cheng tissue is like a fingerprint that is specific to its molecular makeup. Utilizing an AI machine learning algorithm trained with thousands of data sets, SPECTRA IMDxTM can identify the measured Raman spectrum that is of a high risk of being early gastric cancer.
The uniqueness of Endofotonics stems from its SPECTRA IMDxTM solution that allows diagnosing early gastric cancer tissues with a specificity of more than 80 percent compared to the standard white-light endoscopic diagnosis, which yields positive biopsies at a specificity of about 50 percent. This early detection with high specificity will allow the clinicians to treat patients through drugs or minimally invasive therapeutic procedures like Endoscopic Mucosal Resection (EMR) or Endoscopic Submucosal Dissection (ESD). Not to mention, in the current standard of care, after the clinician distinguishes the suspicious lesions through white-light endoscopy, narrow-band imaging is further utilized to study the area for diagnosis. However, this arduous process also demands an experienced and well-trained clinician. “Our IMDx probe is designed to fit into standard endoscope’s operational channel of 2.8 mm diameter. This allows the solution to be used with most endoscopes,” states Cheng.
For the future, Endofotonics is aiming to obtain HSA and CE certification in 2021 and regional certification in SEA in 2022. In order to have a stronger presence in the market, the amalgamated team of scientists, engineers, and clinicians at Endofotonics had spared no effort to deliver a simple and impactful solution. In spite of being a truly groundbreaking solution, the SPECTRA IMDxTM is awaited to be launched commercially. The initial launch of SPECTRA IMDxTM will be SEA with a focus to bring the product into the China market by 2024-25. Also, the additional expansion of indications into the oesophagus and colon area to open the Europe and USA market is planned. Again, Endofotonics is actively looking for more clinical or government collaborations to address the early diagnosis of gastric cancer.