The mammogram has been the gold standard for breast cancer detection since at least the 1960s, helping to lower mortality rates and catch tumours sooner. But what if there’s an even more effective way to screen for tumors?
Bob Shepherd,
“The magic really happens in the technology; having the ability to bring that innovation to a real, user-friendly, and available format.”
Syantra
Imagine a screening method that’s more accurate in early detection than a mammogram and less expensive than an MRI. That’s the idea behind a breast cancer blood test that Calgary’s Syantra hopes to bring to market this summer.
Founded in 2016, Syantra spun out of the University of Calgary, where co-founders Dr. Kristina Rinker and Bob Shepherd were developing a biomarker and drug discovery platform that could detect unique patterns of gene expression. While initially focused on cardiovascular disease, Rinker and Shepherd later applied the technology to breast cancer, developing a proprietary biomarker combination for the disease.
Unlike a traditional cancer-catching blood test, Syantra’s test—Onco-ID— doesn’t actually screen for cancer at all. In a standard cancer blood test, physicians look for what’s known as circulating tumour DNA (ctDNA), which are dead cells and remnants of DNA sloughed off by cancerous tumours. Onco-ID instead looks for patterns of gene expression in the blood that indicate the body’s immune response to cancer. By measuring those signals, the test can triangulate cancer’s presence long before enough ctDNA has been shed to be detected in a standard test.
Based on those signals, Onco-ID uses machine learning to scan for a unique set of biomarkers indicative of breast cancer.
“It’s a pretty standard process,” Shepherd told BetaKit. “The magic really happens in the technology; having the ability to bring that innovation to a real, user-friendly, and available format.”
A problem in need of solutions
Syantra’s test comes at a time when breast cancer rates are rising, but also as health officials are increasingly recognizing the limitations of traditional mammography in early-stage detection.
Roughly 40 percent of women have what’s known as high breast density—an attribute where the breast is made up of more fibrous and glandular tissues than fatty ones. While incredibly common, women with higher breast density are more susceptible to breast cancer, according to the US Centre for Disease Control. Alarmingly still, the condition can also obscure tumours during mammograms, prompting the US Food and Drug Administration to update its regulations around mammography in 2024 to require breast density reporting. Syantra sees its test as a solution to that problem.
The company has been in the process of commercialization for several years, even going so far as to run a pilot project in 2021 that saw the Alberta College of Physicians and Surgeons approve the test’s rollout in Calgary. Syantra has since ceased that pilot project, choosing to go back to clinical trials in a diversified format after the COVID-19 pandemic ended.
In its early days, Alberta Innovates supported the company, and it has also continued its relationship with the University of Calgary throughout its years as a private company, as well as working in concert with Cornell University in the US. Most recently, the company received a $2.4-million USD grant from the US Department of Defence, which Rinker says is interested in the logistical opportunities a non-invasive blood test offers for military personnel stationed away from oncology departments or mammography machines.
Now, Syantra is preparing for a more widespread and formal dive into commercialization, as it wraps up years’ worth of human trials in Canada, the US, and the United Kingdom. Rob Lozuk, Syantra’s CEO, told BetaKit in an interview that Syantra is planning to release its updated clinical trial data around May of this year, with its early-access program slated to be available to the public in select locations across Canada, Europe, and the US this summer.
“Data is king. You need to establish statistical relevance. You need to establish statistical power. That’s what the last eight years have been spent on. The culmination of all that work and the foundational study that will be released in the coming months has been years of work,” Lozuk said.
That work has also been critical in ensuring that provincial healthcare authorities in Canada and private insurers in the US can cover the costs of the tests. Right now, Lozuk said Syantra has comparable testing costs to Cologuard (a stool test for colon cancer), at just over $500 per test. Internally, the company has modelled its cost around a viable cost of around $350.
“We’re working with all the organizations, clinicians, and opinion leaders to get [Onco-ID] to more reimbursement, then to more extensive coverage, and then, eventually, to being incorporated into clinical guidelines. Approval and market access are a kind of first step in that pathway,” Rinker said.
Variants
Onco-ID is, thus far, breast cancer specific, and while Syantra has ongoing projects to adapt machine learning toward lung and pancreatic cancer, the company isn’t trying to be everything to everyone.
Some tests, like Galleri or CancerGuard’s multi-cancer early detection test, can screen for more than 50 cancer variants. Lozuk said Syantra is trying to focus on tackling problems one at a time.
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“We’re focused as a company on solving very distinct problems like the one with breast cancer,” Lozuk said. “It’s not ‘go get an annual blood test, and we’ll tell you what type of cancer, but we only get it right 10 percent of the time.’ We’re going to get it right, but we’re going to tackle that one by one.”
Still, the opportunity exists. As Shepherd puts it, it’s mostly about training machine learning software to recognize the distinct markers of different types of cancer and differentiate between their commonalities and differences.
“What we’re doing is leveraging that commonality between how the body or how cancer reacts with immune cells, and now we’re specifying what that patterning looks like,” he said. “What are the particular biomarkers for the different cancers so that the overall concept can now be turned into individual tests?”
BetaKit’s Prairies reporting is funded in part by YEGAF, a not-for-profit dedicated to amplifying business stories in Alberta.
All images courtesy Syantra.