3D printing is capturing attention in the field of medicine of late. With the first 3D-printed drug being approved for the treatment of seizures, eight years ago, it was a consequential moment in healthcare, following which biotechs raced to step up personalized treatment. Now, with Chinese healthcare company Triastek turning heads after announcing promising clinical trial results for its ulcerative colitis drug, the many applications of 3D printing are being recognized. Among the key players in the field is biotech startup Carcinotech, a company that is looking to bring its 3D-printed tumors to the forefront, to improve cancer care.
Based in Edinburgh in the U.K., Carcinotech was set up five years ago, after its founder Ishani Malhotra came up with an idea that could address the current challenges faced in developing cancer drugs. As 22 million people are predicted to be diagnosed with cancer by 2030, according to the World Health Organization (WHO), there is all the more reason to confront problems like inaccuracy, high costs and outdated techniques, when manufacturing drugs, so that patients don’t lose out on potentially life-saving treatments.
And to battle these issues, Carcinotech now commercializes its 3D-printed tumors globally, to pharma companies, pathologists and surgeons to accelerate drug discovery, with the hopes of driving more cancer treatments to market.
Carcinotech’s approach: replicating the tumor microenvironment
The young startup’s Carcino3D technology is built on the concept of replicating the tumor microenvironment (TME) as it is in the patient, through 3D bioprinting. Carcinotech’s team of scientists examine each cancer of interest, and focus on the key cell types that are to be assessed and targeted using the company’s 3D-printed tumors, explained Malhotra, who is also the CEO of the company.
“The TME research determines key proteins that we incorporate as part of the extracellular matrix (ECM), to ensure we fully replicate the TME as it is in the patient. The research ensures that we produce our 3D-printed tumors with a custom panel of key cells and ECM, customized to the cancer of interest,” said Malhotra.
From a single biopsy – which consists of a patient’s blood and tissues – the company is able to generate more than 400 printed tumors.
Integrating automation to speed up manufacture
To tailor the mechanism for each cancer type, the bioprinting process is optimized, after which rigorous tests are conducted to confirm whether these cell types can be used for drug testing.
But how is it certain that these 3D-printed tumors work effectively?
As each cancer type is tested against the standard of care treatments that patients undergo, be it chemotherapy, immunotherapy or surgery, whether the 3D-printed tumors accurately respond to these therapies just like how a patient’s tumor would, is crucial to validate the printed tumor’s usefulness.
“This ensures that we are fully confident that our 3D-printed tumors can provide robust, reliable, and consistent data to our clients,” said Malhotra.
Besides, during the different stages of development of these tumor models, whether it’s during cell culture, bioprinting or drug testing, Malhotra added that the technology integrates automation to speed up the processes. The company takes it up a notch, and blends robotic manufacturing to achieve reliable results. Since all the data is stored digitally, it adheres to the Data Integrity ALCOA+ – which stands for attributable, legible, contemporaneous, original, and accurate – principles, which was introduced by the U.S. Food and Drug Administration (FDA) to establish that data regulations are in place.
Cancer treatments headed towards precision medicine?
Typically, traditional tumor models can take around three months to be developed. They are also not very compatible with automated systems. On the other hand, 3D-printed tumors overcome these problems, and are also highly reproducible, unlike the conventional models.
“Carcinotech is unique in its offering. While there are thousands of businesses working hard in the industry to advance their technology to offer better solutions to cancer research, drug development and manufacturing, Carcinotech is the only business in our field to be using 3D-printed living tumors,” said Malhotra.
“Most of our competitors are working with 2D models that are not representative of real-life tumor within a patient. Therefore, our technology allows for more robust data in drug screening/testing as our 3D-printed tumors are far closer to the patient’s biopsy.”
As the medtech company’s models are derived from patient-specific cancer cells, it looks to drive precision medicine, an approach where treatment plans are attuned to a patient’s individual needs, to obtain the best outcomes.
“Carcinotech’s vision is to be at the forefront of cancer drug testing, and provide personalized medicine testing to each individual suffering from cancer to better their chance of treatment and survival. Our technology offers surgeons and oncologists the opportunity to test treatment options and create personalized treatment plans for each individual patient,” commented Malhotra. “This could be revolutionary for the way we treat cancer, moving away from a ‘one treatment fits all’ approach.”
Carcinotech overcoming roadblocks
While the company was able to tackle having to replicate the tumor microenvironment through continuous experimentation, one thing it had to really master was being able to recreate the immune system of the patients within the tumor microenvironment.
Malhotra said: “Through our research, we have overcome this major obstacle, and our immune-oncology-focused printed tumors are developed from the patient’s own immune cells, solving this challenge and advancing the capabilities of cancer research.”
As it overcomes these barriers through expedited research, one commercial challenge that the company faces is the adoption of the startup’s technology within the pharma and contract research organization (CRO) sectors. However, Malhotra explained that its product is now gaining recognition, and taking off within these sectors.
Having secured a grant from Scottish Enterprise and won several business competitions, the company had initially raised £1.6 million ($2.02 million), to launch Carcinotech. It is currently raising series A funding, and makes money from sales from drug testing.
Significance in cancer research
Since 90% of drugs fail clinical trials, and, on top of that, because traditional drug testing methods are expensive and sometimes unpredictable – thereby falling short of bringing new therapies to market – it calls for more emphasis to be given to drug screening research.
Malhotra pointed out that the Carcino3D technology might just solve these problems. Plus, as more than 93% of experimental cancer drugs that are tested on animals don’t make it past clinical trials, according to PETA, this technology could eliminate the need for animal testing altogether.
As the company has developed printed tumors for brain, lung, breast, colorectal and ovarian cancers with characterized patient populations and mutational status, the mechanism can also help create solid tumor models. Carcinotech offers drug testing to be carried out at its facility, as well as for the 3D-printed tumors to be cryopreserved and shipped to its clients.
This allows doctors to perform personalized medicine testing. Malhotra said: “Our technology allows surgeons and oncologists to test treatment options and drug responses, and create treatment plans for each patient.”
Scope of 3D-printing in healthcare
In oncology, 3D-printed models can give researchers an idea about the process of cancer growth, and can help with surgical planning, as well as allow for specific cancer types to be identified rapidly.
And besides oncology, there is growing interest for its use in creating prosthetics and even replicas of bones and organs. As a global prosthetist shortage – particularly in poorer countries – combined with excessive rates, deter the millions who are in need of prosthetic surgery from getting it done, 3D-printing promises to jump these hurdles and make prosthetics more accessible.
Moreover, with the development of 3D-printed skin for burn victims, and dental crowns to cover up tooth decay, its applications are abundant.
“The growing use of 3D printing is innovating healthcare at every level, unlocking the potential to solve some of the industry’s biggest challenges. And at Carcinotech, we want to do the same. Our 3D-printed micro-tumors address some of the biggest challenges facing the oncology field,” said Malhotra. “The use of 3D printing is fundamental to the success of our technology in practice.”