Matt De Silva was working as a hedge fund manager with Thiel Capital in the fall of 2013 when he got the news that his dad had brain cancer — specifically, a Glioblastoma multiforme, an aggressive form of brain cancer.
There are very few treatment options for this type of cancer. De Silva’s father was told he had about 3-6 months to live even with chemotherapy and radiation. Most patients live 15 months with this kind of cancer.
It was a devastating blow, but de Silva was determined to find a better option for his dad. A bit of research into alternatives gave him an idea. He could use the known molecular structures of a combination of already approved drugs to fight the aggressive tumor mutations.
“It became apparent to me that doctors and patients are open to this approach, but lack enough data to implement it,” he said.
This convinced De Silva to pair up with his running buddy and pre-med student Pete Quinzio to found the Y Combinator-backed Notable Labs, a personalized testing service for brain cancer patients that prioritizes combinations of FDA-approved treatments that can be immediately prescribed by a doctor.
Normally, an idea like this wouldn’t be scalable. The process would be long and expensive, and there wouldn’t be enough data to start with. It takes an average of 12 years and $2.9 billion to put a new drug on the shelf, and even then, most of these types of tumors mutate, leaving the drugs ineffective in future treatments.
Notable Labs cuts down on the guesswork and testing time in the lab with the use of predictive analytics from another YC-backed startup, Atomwise. It then uses a customized machine that can test thousands of combinations of drugs within the lab in a short amount of time.
It became apparent to me that doctors and patients are open to this approach, but lack enough data to implement it.
During a tour of the lab, De Silva showed me the rented desk space and the millions of dollars worth of lab equipment at his disposal throughout the shared lab. Then he steered me into a bio storage room with a custom-made machine that runs on Python to show me how it all works.
One of the scientists donned blue rubber gloves and was working with dishes of tumor cells inside a glassed-off testing area. De Silva pulled out a clear box filled with red liquid from a refrigerator in the corner of the room. The box was the size of a Tupperware sandwich case.
“See those tiny, floating specs in the liquid? Those are my dad’s tumor cells,” he told me.
De Silva explained how brain cancer cells and their various mutations make ideal subjects for testing. “They grow quickly and readily in three dimensions as spheroids, simulating actual tumors,” he said.
Testing can be done in various mutations, and myriad combined drugs can be updated for the individual patient on the fly using the Notable Labs method.
De Silva then pulled out a black carton punctured with tiny squares and explained how the liquid and cells get dropped into each square. The cells float to the bottom and are put into the special machine for a series of tests. Various mixtures of drugs are added to each square to see what works the best on that particular tumor. Combinations of each drug are then prioritized for efficacy, safety and tumor penetration and then sent to the patient’s doctor to evaluate.
Notable Labs is exclusively focused on brain cancer treatments right now. There are various reasons for this, but the biggest for De Silva is the fact that brain cancer patients have so few alternative options at the moment.
Unfortunately Notable Labs could not find a combination quickly enough to save De Silva’s dad. He succumbed to his brain cancer a week and a half ago, exactly 15 months since his diagnosis.
I asked De Silva how he was able to carry on with a fledgling startup so soon after losing his father. He told me with a sense of purpose in his voice that he was more determined than ever to find a better option of treatment for cancer patients like his dad.
“My dad is why Notable Labs exists,” he said.