Residual Cancer Detection Company Launches, Raises $56M

(Ahmad Ardity, Pixabay)

16 Nov. 2022. A start-up enterprise developing personalized liquid biopsies for finding residual cancer in patients is beginning work and raising $56 million in venture funds. Haystack Oncology, in Baltimore, is founded by researchers in cancer detection and analysis at Johns Hopkins University, who previously started companies developing early cancer detection technologies.

Haystack Oncology began in 2021 to develop blood tests that provide more accurate and timely readings of continued cancer presence in patients to guide treatment decisions. The company says its liquid biopsies analyze blood samples for circulating tumor DNA, fragments of specific cancer-causing genes broken off from tumors and traveling through the blood stream. The volume of circulating tumor DNA in blood, however, is typically quite low, requiring highly sensitive methods for detection and analysis. But because liquid biopsies require only simple blood samples, they can be taken more frequently than surgical tissue biopsies and offer promising tools for early cancer detection and disease management.

Haystack Oncology’s scientific founders are Johns Hopkins University medical school faculty and cancer researchers Bert Vogelstein, Kenneth Kinzler, and Nickolas Papadopoulos. As reported by Science & Enterprise in May 2019, Vogelstein, Kinzler, and Papadopoulos founded the company Thrive Earlier Detection Corp. that applied circulating tumor DNA capture and analysis to early-stage cancer detection. In January 2021, that company was bought out by Exact Sciences, a provider of non-invasive early cancer detection tests, also co-founded by Vogelstein and Kinzler.

In this case, Haystack Oncology is applying circulating tumor DNA to measurement and characterization of minimal residual disease or MRD, the cancer remaining in a patient after treatment. Cancer patients often receive chemotherapy for MRD after primary therapy, such as tumor resection surgery, to reduce the likelihood of the cancer recurring.

First identify specific cancer-causing mutations

The Haystock technology aims to provide cancer specialists with a tool for detecting MRD in circulating DNA from a patient’s tumor in blood samples to determine the need for follow-up chemotherapy. The company uses whole exome sequencing — analysis of genes coding for proteins — from the patient’s tumor tissue to identify specific cancer-causing mutations. Subsequent Haystack blood tests then seek out precise circulating tumor DNA reflecting those mutations.

A team from Johns Hopkins tested this approach in a clinical trial among patients with stage 2 colon cancer, where the cancer spreads to the colon wall, but not to lymph nodes, and is still considered treatable. The 455 participants were randomly assigned on a two-to-one basis to receive treatments guided by precision circulating tumor DNA analysis or standard cancer care. Results of the trial, published in June 2022, show fewer patients receiving precise circulating tumor DNA analysis than standard care needed follow-up chemotherapy. Yet, patients not receiving chemotherapy survived as long as chemotherapy recipients for up to three years, without their cancers recurring.

“Detecting MRD has long been akin to looking for a needle in a haystack,” says Haystack Oncology’s CEO Dan Edelstein in a company statement. Edelstein adds, “Haystack’s mission is to deliver earlier, more precise detection of residual and recurrent tumors to personalize therapy and dramatically improve outcomes for patients with cancer.”

Haystack Oncology is raising $56 million in its first venture round, led by biomedical investor Catalio Capital Management in New York that helped start the company. Taking part in the round are medical diagnostics company Bruker, Exact Ventures — the investment arm of Exact Sciences — and Alexandria Venture Investments.

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