Joanna Nathan (right), CEO of Prana Thoracic, accepts the MedCity INVEST Pitch Perfect award from Arundhati Parmar (left), editor-in-chief of MedCity News, May 22.
Lung cancer is the leading cause of cancer death in the U.S., taking more than 127,000 lives each year. Most lung cancer cases are diagnosed after the disease has already spread, which greatly limits a patient’s chances of survival.
One of the major reasons lung cancer is such a big killer is “because physicians don’t have the right tools to provide patients with definitive answers on what’s going on after they get screened,” said Joanna Nathan, CEO of Prana Thoracic, in a recent interview.
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Nathan co-founded Prana last year with two thoracic surgeons, Rick Fischel and Ed Boyle, to provide physicians with a device that would enable faster lung cancer diagnoses and more precise treatment plans. On May 22, judges crowned Prana the winner of the medical devices track of the MedCity News INVEST Pitch Perfect contest, favoring it over five other startups in the space.
Prana’s technology — which was developed on the Texas Medical Center campus in Houston — dates back to 2015. The startup, which is still based in Houston, emerged from stealth last year. It currently has six full-time, in-person employees.
The company’s team is working to ensure that the screening and intervention process for lung cancer catches up with those of other common cancers, such as breast, prostate and colon, Nathan declared.
Guidelines stipulate that adults ages 50-80 who have a smoking history should be screened for lung cancer. About 15 million patients qualify for this lung cancer screening, but the tools that doctors currently use for these screenings don’t always help them reach conclusive answers about the presence or acuity of cancer, Nathan explained.
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When a high-risk patient gets an X-ray or CT scan of their lungs and it comes back abnormal, there are typically three scenarios that can play out, she said.
The first is a needle biopsy. These really only work when a lung nodule is at least 2 centimeters long, and a nodule that big usually means that the cancer has been developing for a while, Nathan pointed out.
“You can try to get to it with a needle, but the challenge of that is that a lot of the time, you end up giving the patient an inappropriate answer. This can be an indeterminate diagnosis — a lot of the time, physicians tell patients ‘We don’t actually know what’s going on, even though we tried to get it’ — or it’s a false negative — meaning the patient actually has cancer but the physician tells them that they don’t,” she explained.
Invasive surgery is another course of action. Surgeons perform about 40,000 surgeries each year in the U.S. “just to figure out what is going on in a patient’s lungs,” Nathan said. As with any invasive procedure, this option carries risks — such as long recovery times, scarring, infection and anesthesia complications. Additionally, about 20% of these operations end up being done on benign lung nodules, causing the patient to have had a part of their lung removed “for no reason,” Nathan pointed out.
The final option is watchful waiting, but Nathan argued that this is also risky. Cancer notoriously moves fast, and waiting a few months before taking action can be the difference between curable and incurable cancer.
The device that Prana is developing, called the ThoraCore system, is an electrosurgical instrument designed for the minimally invasive, single-port excision of targeted lung tissue. It has a specialized anchor that targets the lung nodule under computed tomography guidance. The device uses bipolar radiofrequency to seal the incision, which minimizes bleeding and air leaks, Nathan said.
“Our initial target is getting enough tissue not only for a diagnosis, but also enough for all of the molecular testing that needs to be run today to create the idealized treatment pathway for that patient,” she explained.
Needle biopsies and invasive surgery are good options for lung nodules that are larger, but surgeons don’t have a minimally invasive tool to help them extract smaller and intermediate-sized nodules, Nathan said.
Investors are enticed by the technology Prana is developing and its potential to innovate the lung cancer detection space, given that the disease accounts for more than 20% of cancer deaths. Earlier this year, Prana announced its Series A funding round, in which it garnered $3 million in new capital from venture funds including New World Angels and Johnson & Johnson Innovation.
The startup is planning to use these funds to launch its first in-human study for ThoraCore at the end of 2024, Nathan said. The company has already tested the device in large animals.
Photo: MedCity News
