Novel c-Met Protein Targeted Molecular Imaging of Cancer with the SurgVision Endoscope Explorer
To deliver a revolutionary optical cancer screening solution that combines a unique biomarker with a novel imaging device, addressing a significant gap associated with current screening methods (high cancer miss rates, poor visualisation). Project outputs will determine which of a number of possible indications to take forward to full stage clinical trials and provide data to support regulatory submission and help to obtain "an indication and diagnostic" label.
Enhanced in-vivo screening and molecular analysis for colorectal cancer
Small Business Research Initiative
Abstract: Colorectal Cancer (CRC), also known as bowel cancer, is the third most common cancer diagnosed in men and second most common cancer in women, affecting 1,361,000 people worldwide each year. It is also the second most common cause of cancer related deaths, contributing to 737,000 deaths every year (Globocan, 2012). CRC is a slow growing tumour that develops over a period of 10-15 years, but symptoms are not obvious until the more advanced stages of the disease. Screening, which aims to identify and remove polyps earlier whilst they are still in a precancerous state, has been shown to be effective in reducing the mortality from CRC (American Cancer Society, 2011). Screening guidelines vary by geography, but generally comprise a mix of fecal occult blood testing (FOBT) and colonoscopy, from a starting age in the range 50-60 years (Brit.Soc.Gastro guidelines, 2012; NCCN Clin.Prac. guidelines, 2015). Typically, an FOBT primary screening test is first administered. Patients with positive results are considered a high risk population and referred for colonoscopy. In routine clinical practice, white light (WL) colonoscopy is widely used for detecting polyps in the colon, but has a detection "miss-rate" of up to 26% (van Rijn et.al., 2008) for small (<10mm) and approximately 11% (van Doom et al, 2015) for flat adenomatous lesions and frequently also misses flat neoplastic lesions (Burgraaff, 2015). This high miss rate is partly a result of technology limitations and partly reflective of the fact that GI endoscopists are challenged to effectively administer the associated clinical workflow within their constrained schedules. Further, the current colonoscopy workflow is associated with a high degree of patient inconvenience and is widely seen as a non-optimal diagnostic modality (because of the miss rates), to be deployed as infrequently as possible. Since patient risk prognostication and subsequent management paradigm are based substantially on size, number and location of polyps detected during WL colonoscopy, there is therefore a substantial unmet clinical need associated with an enhanced clinical workflow yielding more sensitive diagnosis and more precise patient stratification. Accurate prognosis and diagnosis in turn dictate the subsequent surveillance and broader intervention path. Further, missed flat neoplastic lesions (false negative results) may result in patients being detected at later stages, when management has high cost and morbidity and may no longer be curative. Notably, early CRC detection is associated with a management cost and 5 year survival of £12,455 and 70% respectively, while late detection is associated with a management cost and 5 year survival of £25,703 and 12% respectively. Applicant (Edinbugh Molecular Imaging, or EMI) is developing an imaging agent (EMI-137) with demonstrated potential to enhance the sensitivity of colonoscopy, thereby more accurately diagnosing and prognosing patients and assigning appropriate management strategy. This application describes how EMI plans to partner across the UK infrastructure to demonstrate the validity and utility of this technology, delivering on its potential to better stratify patients at risk for CRC.