Roundworms have a stronger sense of smell than dogs. A Japanese company is taking advantage of this and developing a new test kit for pancreatic cancer. This could be the pioneer for the timely diagnosis of other types of cancer.
Pancreatic cancer is considered to be one of the deadliest cancers of all, and one that is also difficult to diagnose. Now tiny worms are supposed to help track down the cancer cells. A Japanese biotech company says it has developed the world’s first early detection test for pancreatic cancer that uses the worms’ sense of smell.
Since mid-November, Tokyo-based Hirotsu Bio Science has been selling its “N-NOSE plus Pancreas” test directly to customers in Japan, to whom the product is to be shipped from January. In 2023, Hirotsu also wants to launch the test in the USA. Users send a urine sample to a laboratory using a special postal bag, where it is placed in a Petri dish containing nematodes. According to the company, the worms, scientifically known as Caenorhabditis elegans, have a much stronger sense of smell than dogs, for example, and follow it to the cancer cells.
This makes the worms, which are only a millimeter long, an effective diagnostic tool, says company founder and managing director Takaaki Hirotsu, who has been researching them for 28 years. “In the early detection of cancer and related diseases, it is very important that we are able to detect very small amounts,” he explains. “And when it comes to that, I don’t think machines stand a chance against the abilities that living organisms have.” Hirotsu Bio launched its first “N-NOSE” test in January 2020. According to the company, this can diagnose the cancer risk regardless of the type of cancer and, according to Hirotsu, has a sensitivity of 86.3 percent.
About 250,000 people took the original test, with about five to six percent showing a high risk. In the latest version, the company modified the nematode’s genetic code so that it swims away from pancreatic cancer samples. In the coming years, the company plans to launch targeted tests for liver cancer, as well as for cervical and breast cancer. The test kit for diagnosing pancreatic cancer costs up to 70,000 yen (about 487 euros), which is comparatively expensive for a diagnostic test in Japan, which has a national health system and fixed prices for drugs and procedures.
The award and the TV ad featuring cartoons of worms and pancreas are part of brand building, Hirotsu says. However, as the company grows, the price may come down. Some doctors criticize this direct approach to consumers and question the medical benefits of the results. The number of false-positive cases could far outnumber actual cases of pancreatic cancer, rendering the results “unusable,” says Masahiro Kami, head of the Tokyo-based think tank Medical Governance Research Institute.
The company counters that the accuracy of N-NOSE compares well with other diagnostic tests and that it is intended as an early detection tool. This could lead patients to further tests and treatments sooner.