Breast cancer: Reining in the Emperor of All Maladies

A Bengaluru laboratory OncoStem Diagnostics brings a ray of hope for low-risk breast cancer patients in India.
CEO and founder of OncoStem Diagnostics, Manjiri.
CEO and founder of OncoStem Diagnostics, Manjiri.

Thirty-one-year-old Marie would have undergone chemotherapy but for Dr Manjiri Bakre and her OncoStem’s CanAssist-Breast test. The test showed that the newly married woman belonged to the low-risk category. She would have also been put on hormone therapy for five years and not conceived for six years had she undergone the traditional treatment. In the aftermath of the CanAssist-breast test, a happy and relieved Marie conceived and delivered a healthy baby. 

Every year, nearly 1.5 lakh Indian women are detected with breast cancer. And with no affordable tests to predict the risk of cancer recurrence, a majority of early stage patients (Stages I/II) undergo chemotherapy fearing relapse. In India, 95 percent patients undergo chemotherapy despite half of them being in the early stages. As a result, these low-risk patients suffer various toxic effects that reduce their quality of life. 
The development and validation of a new test has come as a boon for such patients. Nearly 75 percent of 300 patients who underwent OncoStem’s CanAssist-Breast test have been spared from the highly costly/painful sessions.

Usually for breast cancer patients, surgery is advised for removal of tumours and to prevent its recurrence, chemo/radiation and other therapies are advised. Doctors say the recurrence risk in breast cancer is 15 percent. However, 95 percent still undergo chemo.The brain behind this test—Dr Manjiri Bakre—says that this test can potentially spare over 60,000 breast cancer patients in India and about one million patients worldwide every year from the severe side effects and unnecessary costs of chemo.

As the CEO and founder of OncoStem Diagnostics, 48-year-old Manjiri, who did her PhD in Cell Biology from the Indian Institute of Science, has many laurels to her credit. She says, “The cheapest chemo comes to around `10,000 per cycle and on an average, a patient needs 6-10 cycles. So, if an early stage patient undergoes our test, the savings will be huge.”

Nowadays, breast cancer treatment is decided depending on tumour size, patient age, disease stage, tumour grade and bio-marker. Manjiri explains, “The risk of cancer recurrence is dependent on tumour type, stage and biology of each tumour. The protein present in the tumour responds or does not respond to treatment and clinicians have to assess depending on tests.” At present, a patient’s tumour is routinely sent to a lab for cancer bio-marking. But when the sample comes to OncoStem, they run the ‘CanAssist-breast’ test which gives the risk score of the patient. This report is further sent to the clinicians who will make an assessment based on various parameters and advise whether the patient needs chemo or not.

Based in Bengaluru, OncoStem developed and carried sample testing across India. The development and accreditation took almost five years (2011-16) and was released in 2016. Close to 1,500 samples were tested for five years. Manjiri adds, “We have worked with 10-12 hospitals in Bengaluru and other metros for its development. If there is a need, we will set up one more lab either in Delhi or Mumbai but presently, the Bengaluru lab serves our purpose with 20-30 tests per month. The lab is techno-equipped for immunohistochemistry testing. It takes 10 days for each test to be completed.”

Hoping for government support, Manjiri says, “Our test is validated and developed on Indian patients, so we need to get into ICMR guidelines and this will help the clinicians in advising this test for breast cancer patients across India.”

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The New Indian Express