A personal passion for innovation and to make a difference to cancer care.
Nitzan Rosenfeld, CSO and Co-founder, Inivata talks about the personal story behind his scientific career and his path to making fundamental breakthroughs in liquid biopsy
What drove you towards wanting to make a difference in the cancer field and in ctDNA in particular?
I started off my academic career studying physics and then specialized in quantitative molecular biology. During my PhD my father was diagnosed with lung cancer. Within a year, he had died from the disease. My first real encounter with oncologists was sitting “on the other side” of the table with my father as the patient. This focused my mind and highlighted to me the need for applied research that could ultimately have a direct impact on the patient. This prompted me to step out of basic academic research and to start my career in molecular cancer diagnostics, initially as a computational biologist in a biotech start-up company.
In 2009, I moved to Cambridge, UK, to set up a research group at the Cancer Research UK Cambridge Institute (formerly the Cambridge Research Institute) where we started developing methods to analyze cell-free tumor DNA circulating in the blood. This has been the focus of my work and research ever since.
What was it that led you to create Inivata?
In 2012, my team at the CRUK Cambridge Institute published a method we’d developed for gene panel sequencing in plasma DNA, in the journal Science Translational Medicine. We believe this was the first time a gene panel could be run in plasma and detect mutations that were not detected in the tumor. By that time, it had become clear that identifying specific cancer mutations could affect the resulting treatment. I realized that being able to identify specific cancer mutations from a simple blood sample had the potential to revolutionize the way molecular diagnosis was carried out for cancer patients. The challenge was to make these advances available to patients and their physicians.
Beyond your personal association with lung cancer, having lost your father to the disease, what was the commercial rationale to focus on this indication?
The liquid biopsy technologies we develop could be applied to a wide range of applications. To have the most immediate impact on patients, we wanted to develop a test both that clinicians would use for their patients and that payers would fund. Selecting lung cancer was the result of a combination of factors. First, there was an emergence of effective targeted therapies for lung cancer patients that needed molecular profiling. Second, lung cancer biopsies are particularly difficult to take due to the risk of complications and as a result only a minority of patients currently receive molecular classification for their cancer from tumor analysis. Third, with over 220,000 new cases of lung cancer expected in the US in 2019 alone, the need is significant.
How has Inivata changed since you created the company?
When Inivata was created in 2014, there wasn’t even an established reimbursed market for tissue based genomic profiling. Now it is an important part of clinical care and liquid biopsy is increasingly becoming part of the diagnostic and monitoring approach. The field has moved very rapidly over the last few years and Inivata has been at the forefront of clinical implementation of liquid biopsies. The first patient was treated using information from our InVision platform in 2015. Now, InVisionFirst-Lung is available internationally for both commercial and research use. In the US, it is now covered for Medicare patients with advanced (Stage IIIB/IV) NSCLC who meet specific clinical criteria.
How do you keep the pioneering approach to science at the heart of what Inivata does?
In addition to my role at Inivata, I continue to lead the Liquid Biopsies and Cancer Diagnostics academic research group at the University of Cambridge. It is at the forefront of innovation in methods for analysis of circulating tumor DNA and collaborates on an extensive portfolio of clinical studies. Between these, I have the opportunity to be involved in both the rapidly changing landscape of technologies and applications, and the progress in their clinical implementation. I’ve recently co-chaired an international meeting focusing on circulating nucleic acids in plasma and serum (CNAPS). I’m always looking for new ways to develop our product pipeline, and to run clinical studies to investigate future applications of our methods. Staying abreast of developments in this space is how to keep ahead of the curve.
As I look back almost twenty years ago to when my father was diagnosed with lung cancer, there were barely any targeted therapies for patients and diagnosis of the disease relied on histological techniques. Cancer diagnostics has come a long way and I am delighted that my research team and Inivata have been able to play a part in its progression.
 American Cancer Society, Key statistics for lung cancer, 2018; https://www.cancer.org/cancer/non-small-cell-lung-cancer/about/key-statistics.html