In November 2016, German-American entrepreneur Cyriac Roeding read a profile of Sam Gambhir, a physician and scientist at Stanford University School of Medicine, in a magazine. In the article, Gambhir described how he dedicated his career to early detection of cancer, only to lose his teenage son Milan to a very aggressive brain tumor in 2015.
Roeding, the co-founder and former CEO of mobile shopping app Shopkick, was struck by Gambhir’s story and immediately emailed him, asking to meet him. Over the next few months, the pair developed a friendship, and Gambhir became Roeding’s guide through the complex world of biology and engineering.
One day Gambhir came up with his own idea, a poignant one. “Sam asked a simple but profound question,” Roeding recalls. “He said, ‘What if we stopped looking for cancer altogether; what if we didn’t look anymore? What if, instead, we force the cancer to reveal itself?
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With cancer, time is of the essence: the sooner it is discovered, the longer the patient will live. Early detection of cancer has become a key target in oncology – dozens of companies are working on liquid biopsy technology, which analyzes blood samples for DNA fragments released by cancer cells. But that was not enough for Gambhir. His painful personal experience taught him that it was too slow to wait for the cancer to grow big enough to be detectable in the blood, and that told you nothing about where to find the tumor. “We can’t rely on signals from cancer that nature just doesn’t provide to us all the time,” he told Roeding. “But if we bioengineer the signal, then early tumors can become constantly visible.
That’s the premise behind Earli, which Roeding and Gambhir launched together in June 2018. The California-based startup has already raised $40 million from Andreessen Horowitz, Marc Benioff and Khosla Ventures.
Earli’s approach essentially forces the cancer to reveal itself. Bio-engineered DNA is injected into the body; when it enters cancer cells, it causes them to produce a synthetic biomarker not normally found in humans, something like limonene, a chemical found in the peel of citrus fruits. If subsequent breath or blood tests find traces of this biomarker, it could be a sign of cancer.
The next step is to determine where exactly the cancer is in the body. An injected compound forces cancer cells to produce an enzyme which then engulfs a radioactive tracer, making it visible to the naked eye during a scan. Locating the cancer makes it treatable – clinicians can use precision radiation therapy or targeted surgery to then remove it. Earli also plans to use the same approach to target and treat cancer – to kill cells after they are found – although this idea is still in its infancy.
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