Divide and conquer: The way to improve cancer treatment outcomes

In 2019, 4baseCare Onco Solutions was chosen for an accelerator programme run by Illumina, a $4.5-billion biotech company based in San Diego, California. It marked a turnaround moment for the Bengaluru-based company, which had been set up barely a year earlier and had been struggling to get tumour genomics data about the Indian population – since no one in the country had the data.

4baseCare was looking to develop tests for mutations that let cancer cells survive and grow. The results, together with other information, can guide oncologists to choose from a range of targeted drugs most likely to work on the tumour. These drugs either target the mutation itself or help the immune cells identify and attack cancer cells that have developed ways to evade them. However, all the extant tests were based on data from people of European origin. To generate data based on the Indian population, the company had to collect tumour tissue samples from the biobanks of hospitals, and then extract the genetic material from the samples. It was a difficult proposition for a start-up low on funds.

The aim of the Illumina accelerator programme, begun in 2014, was to provide some seed funding, and business and scientific guidance for promising genomics start-ups. The programme gave 4baseCare access to expensive reagents that were used in sequencing. The company collected and analysed samples of over 1,500 patients across 28 types of cancer at its lab in Bengaluru, identifying DNA and RNA mutations across 20,000 genes. This provided insights into the existing mutational landscape that was based on Western population data. It also identified novel biomarkers that are rare and specific to the Indian population.