Cofactor Genomics (YC S15) Pursues RNA Testing, Offers Better Diagnoses Than DNA

http://techcrunch.com/2015/07/31/cofactor-genomics/

by katm • 11 years ago

56 38 11 years ago

davemessina11• 11 years ago

Hi everyone! Dave Messina from Cofactor Genomics here. I'd be happy to answer any questions you might have. We're excited to launch!

Asparagirl3• 11 years ago

What kinds of disorders and diseases will you be testing for?

Will your tests be available direct-to-consumer, or will patients have to go through health provider gatekeeping?

rational-future2• 11 years ago

or will patients have to go through evil health provider gatekeeping?

FTFY :)

davemessina11• 11 years ago

We are looking at Parkinson's, heart disease, and cancer initially.

rational-future2• 11 years ago

Hey Dave, how does RNA sequencing work for an individual customer? Do you plan to have something like the 23andMe collection kit?

In my understanding human cells have may different types of RNA, which one are you sequencing?

davemessina11• 11 years ago

We plan to offer testing through your doctor, rather than direct to consumer.

We are measuring circular RNAs.

salimmadjd• 11 years ago

Congrats! Co-founder of AsthmaMD here.

I'm curious why you are going through doctors and not direct to consumers at the begging? I understand FDA might force you to limit your marketing claims, however you now need to convince both physicians and consumers of the benefits of these tests. No? Where as I would imagine there will be enough early-adopters in the consumer space who'd be happy to pay for a test like this.

You can later move to the physicians space and assuringly get insurance companies cover the costs, when you have been more stablished.

Would love to learn more about your thinking and strategy here.

davemessina11• 11 years ago

It's the fastest way for us to get this powerful diagnosis technology on the market and helping people.

We believe that our RNA test can become a routine part of a doctor's visit, both as an early indicator of disease and — if there is disease — as a means to monitor the effectiveness of treatment.

navi54• 11 years ago

Would you ever hire someone from Europe? And what skills do you seek after in a employee?

daemonk2• 11 years ago

Bioinformatician here. When you say RNA testing, you mean RNA-seq? Gene expression? If yes, then do you think blood samples will be enough to make these type of diagnosis? I imagine you will probably need tissue specific samples to make some of these disease predictions.

davemessina11• 11 years ago

Hi,

Great question.

We're developing tests around a recently discovered type of RNA called circular RNA. Tissue-specific circular RNAs are present in blood, and so that's how it's possible to use a blood test instead of having to go to tissue like you would with traditional mRNA-seq.

bhickey• 11 years ago

Are there some key publications you could point us at? I've been out of the bioimformatics game for a couple of years and I'm always curious to see where the state of the art is at.

daemonk2• 11 years ago

I don't quite understand how just using circ. RNAs would give you better predictions. From the little I've read about circ. RNAs is that they can form from normal RNAs and possibly function in sequestering regulatory small-RNAs.

So you can detect circ. RNA that come from specific tissues and partition those reads out as expression for those tissues? What kind of coverage do you need to do that? Are mRNA circularization rates consistent among different genes?

danieltillett2• 11 years ago

Dave what is the patent landscape like for circular RNA? I hope it is better than RNAi or antisense?

i0002• 11 years ago

Circular RNAs are really "hot" these days. But, one should keep in mind that the amount of virtually all circular RNAs is lower in cancer (compared to non-cancerous adjacent normal tissue), thus they are not very promising as biomarkers. Also, their biological role is unclear. We did comprehensive literature review on this topic and found nothing truly convincing.

jonlucc• 11 years ago

If I find myself in the area, can I take a tour of your lab? I work in pharma and this is interesting to me.

jarmstropreamp4• 11 years ago

Jonlucc, Shoot us an email through the website and I am sure we can set something up.

_ihaque• 11 years ago

How do circRNA-based biomarkers compare to miRNA-based approaches?

carbocation2• 11 years ago

The article has a DNA versus RNA spin that, scientifically, is more of a distractor than anything when it comes to cancer. I understand that for marketing, it's useful.

In blood cell cancers, Steve McCarroll's group has shown that oncogenic somatic DNA changes are readily discovered through routine sequencing, and these are prognostic of poor outcome.[1] If you do this on a pre-disease schedule based on the risk estimates from your first round of sequencing, you will be able to detect blood cell cancers at any stage you like.

In non-blood cell cancers (say, breast cancer), you don't expect to capture any of the tissue-specific cell of interest from a blood draw to determine if there are somatic mutations occurring. However, there is growing evidence that there is often enough circulating tumor DNA in the blood that it can be of diagnostic significance.[2]

In contrast, for diseases that do not involve somatic mutations (in other words, for diseases aside from cancer), an RNA-based assay could be quite interesting. For example, getting better characterization around non-dilated cardiomyopathies would be of broad interest.

1 = http://www.nejm.org/doi/full/10.1056/NEJMoa1409405

2 = https://www.genome.gov/27556716

davemessina11• 11 years ago

Thanks for your comments, and yes, you've got it exactly.

In cancer, both DNA and RNA can be effective diagnostics, and there's been a lot of great work on the DNA side in cancer.

In essentially all other diseases, though, there are changes in RNA but not in DNA.

carbocation2• 11 years ago

I really think that with heart failure, we need the biomarker equivalent of somatic pre-cancerous DNA changes in cancer. But we also need (to steal from the psychiatrists), better endophenotyping, because many different aberrant states lead to very similar clinical syndromes of "heart failure".

A group, perhaps yours or in concert with yours, could both define the disease subsets based on biomarkers and then diagnose/prognose/inform treatment. Surely the same is true for other diseases, this is just one high-impact example.

jeffdavis• 11 years ago

"In essentially all other diseases, though, there are changes in RNA but not in DNA."

Is that true for autoimmune diseases like Type I Diabetes?

mmaunder• 11 years ago

Related: Check out Jorge Soto's talk on NPR's Ted Radio Hour:

http://www.npr.org/programs/ted-radio-hour/

Soto is the CTO of Miroculus and they're using MicroRNA analysis to develop a cost effective way to provide early diagnosis for a variety of cancers.

So far they've made progress with pancreatic, breast and IIRC two others. This is huge because usually cancer is discovered when you become symptomatic which is usually stage three or worse and it's much harder to treat then.

If they can make this cost effective enough to be included in a regular doctor 'check up', then we may catch a large proportion of cancers early which makes treating them way easier.

robbiep• 11 years ago

So they're getting 20k from YC to get valley contacts, at the cost of a percentage of the company, when they already have pharmaceutical and NIH funding? Or is there a different deal in place for biotechs?

davemessina11• 11 years ago

Over half of the YC companies (us included) don't really need the money. The $120k investment is only a small part of what YC does.

See http://www.ycombinator.com/atyc/

Cofactor Genomics (YC S15) Pursues RNA Testing, Offers Better Diagnoses Than DNA

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