Marcel Gehrung, a CRUK PhD student at the CRUK Cambridge Institute, is writing up his thesis, setting up a spin-out company and supporting the response to the COVID-19 crisis by 3D printing PPE visors and developing a social distancing app. His company supports the implementation of the Cytosponge, a minimally invasive method that aids the early detection of oesophageal cancer. In this interview, Marcel tells us how he has kept up his entrepreneurial spirit, resilience and positivity about the future during this time.
How did you come to set up a spin-out company during your PhD?
The Cytosponge® test consists of a ‘sponge on a string’ that can be swallowed as a pill. Cells are collected from the sponge and analysed for signs of Barrett’s oesophagus, a condition that can potentially lead to the development of oesophageal cancer. With the Cytosponge, there is no need to perform an invasive and expensive diagnostic endoscopy.
The idea of the Cytosponge predates me. The test was invented at Professor Rebecca Fitzgerald’s lab, with which I am now collaborating. The BEST3 clinical trial is assessing whether the Cytosponge test is effective in increasing the detection of Barrett’s oesophagus in patients with reflux symptoms in a primary care setting, and to evaluate the cost effectiveness of this approach. The results of this trial were published in July 2020.
I have a computational background and experience in applying machine learning to healthcare data. I had the idea that we could think more broadly around the technology of the Cytosponge. This led to spinning out a company – called Cyted – with Professor Fitzgerald about a year ago. Now I wear two hats: the PhD student’s, and the CEO’s. I am doing both jobs full time!
What is your company’s mission?
Initially, we’re supporting the implementation of the Cytosponge. We’ve partnered with a company called Medtronic to manufacture and provide the device itself, and we are dealing with the samples as they come in. We’re currently working with tests that use cells from the Cytosponge to diagnose Barrett’s oesophagus, but we are working on other tests that might give more useful insights into the details of the diagnosis. For example, what stage of disease is the patient at? How likely is the disease to develop into cancer? It’s not a binary yes or no; there is an entire spectrum of barriers to and drivers of cancer.
Going beyond the Cytosponge itself, we’re using state-of-the-art computational and deep-learning technology to build digital pathology tools and capability. Right now, most pathologists still receive their slides manually and they must put them under a microscope. We want to support the development of an early detection technology environment that enables pathologists to do digital analysis. The technology we are developing is applicable to other areas of early detection of cancer that involve aberrant cell morphology or changes in cell or tissue architecture, not just to oesophageal cancer.
How has CRUK supported your entrepreneurial work?
We have been working with the commercial partnerships team closely. They were not involved in the creation of our company, but we are negotiating a deal with them that will allow us to exploit histological images from the BEST2 and BEST3 trials. We plan to use the samples from the Cytosponge test as a training set to develop our semi-automated detection technologies. We are also currently in conversations with the commercial partnerships team about a patent application.
How has the current situation with COVID-19 impacted you and your work?
It’s been difficult for the company. We are lucky to have finished our first major investment round already, so we are safe in terms of spending runway. I know of a couple of other companies who were very close to finishing deals when the crisis happened, and these deals have been put on hold. Our problems have to do with setting up a company and onboarding people when working from home. It’s supposed to be an exciting time, bringing on new people officially and paying them a salary, but doing all of that from home is incredibly complicated.
And this is happening while I’m trying to write up my PhD thesis. But, in some ways, it has been a good environment for doing this, as having fewer meetings means I have long continuous parts of the day when I can write something.
We have also been using some of our expertise, time and knowledge to support the COVID-19 efforts. We were hearing from nurses at Addenbrooke’s Hospital that there was a lack of personal protection equipment (PPE) such as visors. We know that PPE is needed to administer Cytosponge, as well as performing many other hospital procedures.
So we started to 3D print visor parts in my living room. We also used our time and expertise at home to develop an app that would help people make decisions on which supermarket to go to, based on how busy it was, to support social distancing.
What have you learned from this experience that you can share with others?
I think it’s easy to overlook the pragmatic tips, so I’ll mention one now. Structuring your time, which is something that normally evolves by itself in an office, is much harder to do when you’re at home. At our lab, we make time for coffee in the mornings, but that’s just one way to approach it. There are many tools and ideas out there that can help. Sometimes I think it’s about coming to a state of mind where you say, “I’m fine with this right now and I’m accepting this”. We have to do the best we can for our own mental health.
This experience has taught me how to think more broadly. People say you can’t combine immersion in a topic with breadth. But I think this situation has taught me how to use my skills in a different way. We don’t have to be narrow minded to succeed. You want to have life skills as well, coming out of your PhD, and that doesn’t come from spending weeks and months in a lab or isolating yourselves from other topics away from your project. We have an opportunity now to think outside the box.