Mitra Biotech is a Boston and Bengaluru-based startup that is developing personalized cancer therapies. It focuses on testing drugs on recreated tumor microenvironments in the lab before human trials. This approach has higher success rates and lower toxicity than conventional trials. Mitra Biotech has raised over $27 million to develop these personalized therapies and diagnostics. Major challenges include high costs, ensuring data quality, and coordinating information between different treatment centers.

1. Get the Right Cancer
drug, at Right Time
Case is about Personalized Cancer therapy which is
changing the dimension in Pharma Industry in Cancer drug
development.
By:- Aarya Singh
Ipshita Shukla
Naveen Kumar
Subin Suresh
Kirloskar Institute of advanced
management Studies

2. Case Summary
• Alex suffering from Gastrointestinal stromal tumor has actually lead to coming up
Mitra Biotech cancer diagnostic firm.
• Mitra Biotech is Boston & Bengaluru based startup firm raised 27.4 million funds
for Personalized cancer therapy.
• Success rate for cancer treatment is very low as it takes 2-3 months with various
trial and errors.
• Patients may or many not be benefited from the treatment but higher chance of
suffering toxicity.
• Mitra Biotech is focusing on treating on the cancer tissue rather doing treatment
directly on the Patient.
• Technique is to recreate a micro environment for the tumor in the lab to test
drugs or combination on it.

3. • Only 10% of drugs going through phase-1 clinical trial stage make it to market.
• Co-founder Mr. Sundaram and cancer biologist Pradip Majumder raised $15
million funding during 2010-2013.
• The Potential market for precision diagnostics in oncology is 600 billion.
• Presently they have tied-up with Forties and Apollo in Delhi.
• Major Investors are SEQUOIA, RACAPITAL, TATA CAPITAL, ACCEL partner,
Sands Capital
• Mitra has 2 business Clinical diagnostics and bio pharma.
• Revenue generated was 2 million and the organization is aiming at 2 times.
• The company has raised 183-crore from Sequoia Capital & Sand Capital.

4. • Personalized medicine is used to learn about a person’s genetic makeup and how their tumor
grows. Using this data, doctors hope to find prevention, screening, and treatment strategies
that may be more effective.
• Before personalized medicine, most patients with a specific type and stage of cancer received
the same treatment. However, it became clear that some treatments worked better for some
patients, than for others.
• Target Treatment: A targeted treatment targets a cancer’s specific genes and proteins that allow the cancer
cells to grow and survive.
• Breast Cancer
• Colorectal cancer
• Gastrointestinal stromal tumor
• Kidney cancer
• Lung cancer
• Melanoma
• Pharmacogenomics: looks at how a person’s genes affect the way the body processes and responds to drugs.
These changes influence how effective and safe a drug is for a person
About Personalized Cancer therapy

5. • All India Institute of Medical Sciences (AIIMS) has successfully tested a coded ayurvedic drug for
improving quality of life of breast cancer patients. Under the supervision of Dr G K Rath that drug
testing is carried out over three years.
"Initial reports confirm that the drug is helpful in reducing the side effects like hair fall, nausea and fall in
vital blood parameters,”
• “A new drug for the treatment of cancer" - India, USA, Australia, Canada, Europe, Israel and Japan.
• Novel peptide analogs for the treatment of cancer" – India
• Cyclopentenone derivatives for cancer therapy - India and USA.
• Flavopereirine derivatives for cancer therapy.
• Nano Version of Cancer Drug: first time, a nano version of carboplatin, used in chemotherapy
treatment has been developed, wherein unlike the existing molecule, a higher concentration of the drug
will attack the cancerous cells and increase the chances of survival of a patient.
Five Indian researchers and doctors from the Indian Institute of Technology (IIT), Mumbai; LV Prasad Eye
Institute, Apollo Hospitals, Hyderabad; and Tata Memorial Hospital, Mumbai;
Research and Development happening in India for Cancer
Drug development

6. Additional research is under way to improve cancer
treatment vaccines:
• Identification of many cancer-associated antigens: These molecules vary
widely in their ability to stimulate a strong anticancer immune response.
• Identification of the mechanisms by which cancer cells evade or suppress
anticancer immune responses.
• Immune checkpoint modulators may also improve the effectiveness of
cancer vaccines.
• The modulators target another immune regulatory mechanism used by
cancer cells to evade destruction.

7. Cancer preventive vaccines approved in the United
States:
• Human papillomavirus (HPV) vaccines: Persistent infections with high-risk HPV types can
cause cervical cancer, anal cancer, or pharyngeal cancer, and vaginal, vulvar,
and penile cancers.
• Hepatitis B virus (HBV) vaccines: Chronic HBV infection can lead to liver cancer. The
FDA has approved multiple vaccines that protect against HBV infection.

8. Global Oncology Drug Market:
• Cancer Drugs Market is expected to garner $111.9 billion by 2020, registering a CAGR
of 7.1% during the forecast period 2014 to 2020.
• Global cancer drugs market accounted for $78,238.9 million in 2015, increasing demand
of biological and targeted drug therapies, continuous patent expiry of key cancer drugs
and the rising impact of biosimilars.
• Global Personalized Cancer Therapy Market was valued at about USD 10.0 billion in
2015, and is expected to reach USD 19.3 billion by 2020, growing at a CAGR of 14.1%
from 2016 to 2020.
• North America occupies a larger market share, Asia-Pacific is the fastest growing market
and is also the largest demand market, such as China and India.

10. Major Players
Abbott Molecular (U.S.)
Affymetrix (U.S.)
Almac Group (UK)
Mitra Bitech
QIAGEN (Germany)
Roche (Switzerland)

11. Cancer drug pricing
As per the article BLOOD (American Society for Hematology).
• In 2001, when Imatinib was introduced, costs were high, approximately $30,000 per
patient per year.
• By 2012, the cost had risen over threefold to $92,000 per patient per year,
• U.S. is still the world leader in oncology spending per capita — about $100 per person per
year. average cost of new oncology drugs is $10,000 a month,
National Pharmaceutical Pricing Authority (NPPA) apex body which looks after
the pricing of National List of Essential Medicines (NLEM).
• Cancer treatment in India is economical compared to developed countries.
• Chemotherapy : 30,000-1Lak
• Target therapy: 5-6 session 20Lak
• Radiation therapy: 1.5 lak per cycle
• Breast Cancer: 2Lak

12. Major Issues related Personalized Cancer Therapy:
 Quality Assurance:
• Access to reliable high-quality genetic testing is essential to maximize the benefit that can be derived
from new and existing practices in personalized medicine.
• Reliability and quality of testing can be assured though an effective regulatory framework for clinical
laboratory operations, medical testing, and diagnostic devices.
• The regulatory framework varies significantly from province to province, and national oversight or
guidelines to facilitate harmonization and good practice in all provinces is lacking.
 Cost and Data synchronization:
• Most challenging problem with all of personalized medicine is how we are going to cover the cost of
evaluating patient tumors,
• Next is accumulation of data and information so as to increase the response time quickly and accurately
• National Cancer Institute will “build information platforms to support the integration of genetic information about tumors
with data on how the tumors respond to therapy. This will lead to high precision and accuracy response to treatment.

13. Distribution
• Federation of Medical and Sales Representatives' Associations of
India (FMRAI)
• FMRAI is the only national trade union of the Medical and Sales Representatives in
India having its affiliates in each states of the country and offices in 300 cities and
towns.
• FMRAI is an omnibus organisation of all field workers of nearly all companies having
marketing activity. But for many companies FMRAI function as union of the field
workers with individual companies.
• Tie-up with Oncology department of Hospital for drug diagnostics and
development.
• Development of Genomic facility for (Genomic analysis) and Big data
analysis.