Cervical cancer in Brazil is the third most common tumor among women in the country in regions with a low Human Development Index (HDI), according to data from the National Cancer Institute (Inca). It would be possible to reduce this incidence if women of screening age in the country had access to a periodic assessment of cells in this region.
Ziel Biosciences, startup supported by the Innovative Research in Small Businesses program (PIPE), from FAPESP, developed a self-collector of cervical samples and a rapid test that examines the material obtained instantly — similar to rapid pregnancy tests, for example.
If the result is negative, the woman must repeat it one year later. If positive, she should contact a specialized professional. “The idea is that the test performs screening”, explains Caroline Brunetto de Farias, CEO of Ziel Biosciences. “This guarantees women’s health empowerment: if they have a positive result, they already have an injury and should see a doctor quickly.”
Farias says that, in the project supported by FAPESP, the objective was to discover whether a specific biomarker indirectly pointed to the existence of the HPV virus in order to, in the future, create a rapid test to indicate infection by this agent. “To our surprise, we discovered that it does not detect whether a woman has HPV. In fact, it identifies whether the patient already has an injury.”
A biomarker is an indicator of the differences between diseased and healthy cells. This allows treatments to be more personalized for each case based on targeted therapies. “They help to establish precision oncology by developing specific and less toxic options for each patient.”
According to Farias, it was essential to understand what this biomarker identified to continue the project. “The discovery was very important because it is something very specific.” The team noticed that cancer-free cervical cells do not have the signal, but cancer cells do. And the rapid test indicates a result of injury, but not HPV contamination.
It is true that infection with this virus can lead to cervical cancer, but not all women who have it develop cancer. “The problem is when the microorganism persists because the body cannot expel it. It’s a very silent virus that in two, three, four, five years will cause damage.”
Unreleased test
The self-collector concept is not new, but the startup’s solution — which adds the rapid test — is the only one that performs liquid cytology instantly. “There is no rapid test for cervical cancer in the world. Our patent is precisely for this. And we want to take it both to Brazil and to other places in the world where the reality is very similar to ours.”
Farias says that, currently, the startup has partnerships with city halls so that a health agent goes to women’s homes and delivers the self-collector. “It is for those patients who do not go to the Basic Health Unit (UBS). For those who live in rural areas, are riverside residents, do not have money for transportation, or feel embarrassed because they do not identify as women or for any other reason. They can take the finished result to the doctor so that he knows what protocol to adopt.”
The team does not yet know how much the product will cost when it reaches pharmacies. “After the pandemic, everything changed a lot. The collector, for example, which cost around R$18 to produce, today costs approximately R$40”, he says. “We imagine that the complete test costs around R$50 or R$60.” And, with increased demand, it is possible to reduce these costs.
Furthermore, the kit may be available in the Unified Health System (SUS) — just remember that preventing a disease is much more efficient and economical than its treatment. “The idea is that the woman has the comfort to carry out this analysis without having to talk to someone if she is embarrassed. We want it to be accessible for those who use the SUS, whether in pharmacies or UBS.”
Great extent
In a public health context, this type of solution helps to get more women to be screened. “With this, it is even possible to optimize the use of SUS resources. Some women go to UBS every year, but they could go every two years, for example,” she comments. “The rapid test helps to serve those who need care more quickly and, thus, reduce the incidence rate of cervical cancer in the country.”
Farias says that, today, 40 million women should undergo this screening in Brazil through the SUS (when patients who use the private network are included, the total is 60 million women). “In 2021, the last year for which data is available, 15% of women took the exam,” she says. “And this is a 100% preventable cancer. It doesn’t make sense for it to be the third most common. There’s something about this journey that isn’t being done.”
With a PhD in cellular and molecular biology, Farias chose this area because she wanted to discover a cure for cancer. “I think I was very dreamy, because it is a very difficult task. On the other hand, while a doctor cares for one patient at a time, someone who develops a medicine or a diagnostic test can reach the entire community.”
Currently, in addition to working at Ziel Biosciences, she is a professor at the Federal University of Rio Grande do Sul (UFGRS) and the Federal University of Rio de Janeiro (UFRJ). “One of the subjects I teach in postgraduate studies is scientific entrepreneurship. I want students to think about how to transform a master’s thesis or a doctoral thesis into a product or service that can benefit society.”
In addition to the self-collector and rapid test, Ziel Biosciences is already developing an application to complement the solution. “The woman will take a photo of the quick test, so that the application can interpret the result when the mark is very weak, for example. Then, the application itself will indicate whether she should go to the doctor quickly or whether she should repeat the test after a year.”
It is also worth highlighting that the same concept can be applied to other diagnoses in which the patient can collect cells alone — in blood, saliva or urine samples, for example. “Depending on the type of tumor, if we develop a new self-collector, we can create other rapid tests, always with the aim of guaranteeing this empowerment in health.”
Roseli Andrion | Research for Innovation