The startup OncoSwab wants to make lung cancer detection as easy as flu and Covid-19 tests

Motivation for startups can come from many different sources. For Andrea Stephany, co-founder and CEO of OncoSwab, it came from family. A few years ago, her mother started having a cough and other symptoms that she feared were signs of lung cancer. To find out for sure, she tried to have a CT scan, which is currently one of the standard methods for detecting this type of cancer. It took Stephany’s mother 15 months from the first complaint about the symptoms to the planned CT scan.

“It’s been 15 months of worry and reflection,” Stephany said. “It was challenging to experience firsthand how slow the system can be and how many barriers there are to a potentially poor diagnosis.”

The scan was negative and Stephany’s mother is healthy. If OncoSwab is successful with its research, people like Stephany’s mother will have access to a simpler lung cancer detection test that doesn’t require the time and effort of scheduling medical imaging. The only thing the patient needs for the test is a nasal swab, which can be done in the comfort of home.

While the motivation for OncoSwab came from Stephany’s mother, the roots of the startup’s technology lie at a 2022 hackathon in the Dutch city of Leiden. More than 100 young scientists took part in the multi-day event, where participants were divided into small teams and challenged to find new solutions to global problems. Stephany’s team was among those working on solutions to cancer.

The Covid-19 pandemic was still fresh in the minds of many hackathon participants, including Stephany. She recalled efforts to develop new and better methods to detect the novel coronavirus and was inspired to develop a similar cancer test that analyzes a nasal swab and detects signs of the disease. Stephany’s team won third place in the cancer category.

Lung cancer is often detected using imaging techniques. In addition to a chest x-ray, methods include CT, MRI and PET scans. Not only are these tests expensive and require the patient to visit a health facility, but they are also often too late, Stephany said. Earlier detection allows for earlier intervention when cancer treatment has a better chance of success. Most lung cancers are diagnosed when the disease has reached a more advanced stage, which is why death rates for this type of cancer are so high, Stephany said.

Tumors secrete compounds that can be detected in screening tests. Liquid biopsies are based on the ability to detect biological indicators of cancer circulating in the blood. The idea of ​​using a nasal swab to detect lung cancer is based on the nature of this type of cancer. OncoSwab’s approach is based on evidence that signs of lung cancer can be found in the air we breathe out. Stephany said the pulmonologists she spoke with expressed support for OncoSwab’s approach.

“The tumor is in constant contact with the airway – so some doctors say this makes perfect sense,” she said.

The OncoSwab test is designed for sample collection either at the patient’s home or at the point of care. Nasal swab analysis looks for biomarkers of lung cancer. Stephany said these biomarkers are well known in the cancer research community, but she cannot disclose the specific biomarkers that OncoSwab detects due to confidentiality reasons. She admitted that the startup’s test looks for a combination of biomarkers that are analyzed using a proprietary algorithm. The samples are analyzed in an OncoSwab laboratory. The company has a research and development laboratory in Europe. Stephany plans to set up a U.S. lab when the company is close to commercialization, which she says is still a long way off. The technology will provide a test result within 24 to 48 hours.

OncoSwab, which splits its operations between San Francisco and Corroux, Switzerland, was founded in 2023. Stephany said her conversations with pulmonologists revealed another pressing need that goes beyond screening. When a patient goes to the emergency room for some reason and gets a CT scan, that scan sometimes shows a nodule in the lung that could indicate lung cancer. To get a more definitive answer, the next step is a biopsy. OncoSwab’s test could provide a less invasive way to determine whether a lump is cancer.

“This lung nodule probably can’t be anything, but it could also be cancer,” Stephany said. “The system is too overwhelmed to follow up. 60%, if not more, is completely lost in the system. 60% may be lung cancer.”

OncoSwab isn’t the only company developing a test that detects cancer based on compounds floating around in people’s airways. Like OncoSwab, some of these companies have Covid-19 origins. The breath test Breathe Biomedical is developing for cancer was designed during the pandemic. This breath analysis technology was able to distinguish between people with Covid-19 pneumonia and people without Covid-19 pneumonia. The results were published in March 2024 in the Journal of Breath Research.

Breathe Biomedical’s cancer research began with lung cancer. But in 2023, the company dedicated itself to breast cancer detection. Longer term, Breathe Biomedical aims to further develop its technology into a medical device capable of detecting multiple diseases – a goal shared by many in this growing field. Companies developing tests that analyze breath to detect signs of cancer and other diseases include Owlstone Medical, Pulmostics, Noze and Blu Biotech.

Stephany acknowledged that there are opportunities to apply OncoSwab’s technology to other diseases, including other types of cancer. However, she said the company’s initial focus is on lung cancer. OncoSwab is developing its technology as a lab-developed test that does not require FDA approval. The company is backed by undisclosed pre-seed financing and is currently seeking to raise additional capital to fund clinical research.

Illustration: Blueringmedia, Getty Images