According to a recent article in FierceBio, Andrea Mazzocchi, Known Medicine CEO, is not trying to reinvent the wheel. On the contrary, her company will be providing a tool to assist physicians who rely on biomarkers found in cancer tissue that had been used successfully in the past.

The downside in relying on biomarkers is that they may only be applicable to some patients and not to others. Therefore, despite the many advances, there is still guesswork in attempting to personalize treatment for cancer.

Andrea also mentions checkpoint inhibitors as an example of treatments that help some people but not others. Her goal is to create many types of cells that will provide evidence as to how a tumor will react to treatment.

The Seed Was Sown at Wake Forest University

Known Medicine works closely with the oncologists at the University of Wake Forest, which Andrea says is an extension of biomedical engineering research for her Ph.D. The company’s interaction with Wake Forest keeps it on the cutting edge of treating cancer and staying up to date on new technology.

Known Medicine was launched in February 2020. They applied to Y Combinator’s program that provides seed funding for startups the following month and received $150,000. A schedule of meetings with investors to raise additional funds will follow.

About Cell-Based Models

Cell-based models are structured mathematically and simulate biological cells in tissue. This allows scientists to observe single-cell reaction while attempting to control the cancer.

Andrea explains that her company models many different cell types, such as immune cells or stromal cells, that create connective tissue.

She points out that complications arise relating to driver genes that create malignant cancers. When searching for cancer, scientists often find that there is no obvious driver gene.

Other examples are checkpoint inhibitors. Some checkpoint inhibitors may be effective in treating certain cancer patients but not effective when treating others. Checkpoint inhibitors are proteins that prevent the immune system from shutting down before the cancer is entirely eliminated.

About the Known Medicine System

Known Medicine has moved to the next level of personalized cancer therapy by making every effort to remove the “guesswork”.

The company’s focus is on the FDA-approved standard of care for each type of cancer.

The process begins when a tumor sample is sent to Known Medicine’s lab from a hospital. The company divides the tumor into mini-tumors. Each smaller model is then dosed with a different cancer drug or drug combinations to determine the optimum treatment for the patient.

Andrea also commented that Known Medicine’s system would be valuable in identifying and recommending off label use of chemotherapy for patients whose disease is not readily identifiable.

It is legal for a physician to prescribe a drug that was FDA approved for one disease to treat a completely different type of disease. One out of five prescriptions is written as off label.

About Pleural Effusion

In addition to processing solid tumors, the lab at Known Medicine works with patients who have developed pleural effusion. In pleural effusion, fluids build up along with cancer cells in the area between the chest wall and the lungs.

In general, in working with solid tumor patients, the lab needs a blood and tumor sample. When working with patients who have pleural effusion, only a sample of the fluid is required for analysis.

The fluid must be removed or the patient will have difficulty breathing. Andrea explained that the portion of the fluid that would normally be discarded is separated and cells are removed from the plasma.

Stromal cells, cancer cells, and immune cells are removed from the liquid. After separating them into measured ratios keeping the mini-tumors identical, the cells are put into a culture.

The process for testing solid tumor patients is the same, except that the tumor samples will not include immune cells as they are removed from the blood samples.

Andrea’s partner, Katie-Rose Skelly, added that their analysis involves monitoring the results of the drugs over the long term. She said that they are already considering the use of machine learning to locate cells that are marked for death (pre-apoptotic). These cells appear alive in the test but will eventually succumb to treatment.

Plans for the Future

The two partners hope to bring optimum treatment to patients in record time by forming other partnerships.

• Their first addition to the company would involve doctors at research institutions across the nation.
• The partners agree that their next priority is to have their program fully automated creating an errorless system.
• The partners hope to develop a testing kit that would be used for research followed by a kit for clinical use. They intend to put their product in clinics and hospitals primarily for patients but also to collect data for drug discovery.

Katie-Rose earned her master’s degree in biomedical informatics. She is impressed with the vast amount of information obtained from pictures even those that may not be visible to the human eye.

In the future she explains, they will be able to look at a picture of a mini-tumor that has been treated with a drug and determine the effects of that treatment.

As Known Medicine’s dataset grows, it will be able to locate indicators in images that will predict a patient’s response to treatment and whether the patient will experience side effects.