We probably have all been affected by cancer in some way, either directly or through our family and loved ones.

That is why we often keep a close eye on how innovation is elevating detection and cure within the industry. So when an email crossed our desk about a revolutionary detection method that is scalable, we decided to give it a look.

Fresh off their recent first place finish at the Asia Pacific Accelerator programme from MedTech Innovator, which the largest life science accelerator in the world, X-ZELL is looking to change the world.

For those not in the know, X-ZELL is developing an accurate, affordable, and globally scalable early cancer detection from 10mL blood samples, which is unprecedented. This isn’t their first success at startup programmes and awards, having bagged S$30,000 grant prize from Enterprise Singapore’s Startup SG award.

We explore the growth of digital health in Malaysia with Doctoroncall

The startup is based in Singapore, but maintains their global R&D Centre in Bangkok, Thailand.

We had the chance to ask Dr. Sebastian Bhakdi, CEO of the medtech startup about their experience in the accelerator, as well as how they plan to scale their solution worldwide.

Congrats on winning MedTech Innovator Asia. How was your experience during the programme?

Thank you, it’s been such a wonderful experience to even be part of the MedTech Innovator Asia Pacific program, let alone to win it. We received so much inspiring input over the course of the program, and so much constructive feedback, that it’s almost a little sad to see it come to an end. An important part of the experience were our fellow finalists, of course. If you watched the Grand Final last week, you know why MedTech Innovator is the most important medtech accelerator in the world. The pitches were of such high quality that each contestant would have deserved the win. Genuinely. 

What were some of the highlights or biggest takeaways from this programme?

The various pitches – ranging from one to five minutes in length – were definitely a highlight. They force you to reflect on every aspect of the organization: Why are you doing what you do? What do you want to accomplish? How will you measure success? Who will you take on the journey with you? Revisiting those questions, guided by the MTI team, has been a fascinating experience, especially because we didn’t do it once, but three times – each time in a different context. A 60-second pitch is obviously a lot more restrictive than a five-minute one, but it’s also a great way of putting the company’s strategic narrative to the test. It’s a real litmus test, and arguably also a lesson in humility.

What was the inspiration or reason behind using AI to help create a scalable detection system?

An important point of difference for us is that we own the entire rare cell detection workflow from end to end. Upstream, we have found a solid solution based on proven pathological principles. Essentially we pick up where George Papanicolaou, inventor of the Pap smear, left off in the 1950s. His simple, cell-based approach for the early detection of cervical cancer still is the only screening solution with a proven impact on patient survival. At X-ZELL, we continue that legacy by scanning a small blood sample for atypical cells that could be indicative of early-stage cancers – focusing specifically on tumour-associated Circulating Endothelial Cells, or tCEC. Now the question is how to process all that new information downstream? Papanicolaou examined every sample manually under a microscope. We’ve done that too, and with great success, but it’s not endlessly scalable. That’s why we have developed our very own cell scanning solution and AI. It will allow us to digitize a microscope slide and pre-categorize the cells we see on it, so the pathologist can check it within seconds and sign off on the diagnosis – even remotely.

What will the next five years look like for cancer detection if things continue to progress well?

We are very optimistic that in five years’ time, our first liquid biopsy – an early detection test for patients with suspicion of prostate cancer – will have made the leap from Asia to Europe, and that the next indication will be close to approval, or already approved. We’re already seeing very promising results for both lung and colon cancer diagnostics, for example, so we hope those indications can proceed to the clinical stage very soon. Of course the US is also high in our agenda, so we’ll hopefully be able to establish a presence there, too.

By the end of the decade, we hope we’ll be able to present an affordable pan-cancer test that is able to scan the blood for atypical cells and automatically cross-reference them with our database. 

What are some of the challenges you foresee in bringing your solution to the mass market?

Unfortunately some businesses that came before us have overpromised and underdelivered, so I think one challenge will be to regain basic trust in blood-based diagnostics. Luckily, I think we are slowly making progress here. Secondly, there are a lot of highly funded players in the DNA sequencing market trying to achieve the same as us, so we need to find a way to cut through the noise. MTI has certainly helped us on that front.

Finally, we need to find a way to get to the patient. I think that’s where X-ZELL really is one step ahead, because we slot into existing healthcare infrastructure and work hand-in-hand with key decision makers instead of wanting to disrupt the system from the outside. That way we can create a win-win for service providers and patients, but also those working at the front line. Ultimately it’s a question of resources and bandwidth. 

What’s next for X-ZELL?

X-ZELL has ambitious plans for 2021 and beyond, with the opening of our first European office in Germany and the launch of our first early cancer detection test in Singapore being the most immediate areas of focus. In the mid-term, our goal is to develop additional tCEC tests for the most common types of cancer, with the long-term objective of developing a general screening test based on the data we collect along the way. It’s an ambitious roadmap, but winning the MedTech Innovator Asia Pacific program has reinforced that we are on the right path.