From bench to bedside: Developing early-detection tests for cancer

In an interview with The Business Times, the company’s chief executive Zhou Lihan said Mirxes’ plan was to harness ribonucleic acid (RNA) to detect traces of cancer and other metabolic diseases through blood samples.

The 40-year-old said Mirxes realised that the technology it had developed could capture “some early signals” of disease – even with the patient still largely asymptomatic. These tests, he said, were better than the currently available methods of identification through tumour markers. 

Mirxes’ technology was first used to identify traces of stomach cancer. Zhou, whose uncle was diagnosed with this cancer at a late stage and died within six months, said: “I’ve seen certain cancer patients suffer for several years, but stomach cancer can be cured when detected early.”

Keeping early detection in their sights, his team set to work: “So it was a simple idea at that point. We had seen some good signs, we had the technology. Let’s make the blood test, get it approved and make it available to people… from bench to bedside.”

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Mirxes’ technology has also been applied to identifying early signs of other cancer types such as lung and breast cancers, as well as heart failure and diabetes. 

But Zhou said: “In order to develop this product and for it to be commercialised, we needed to take it into a company setting.”

The two other partners who were to become Mirxes’ co-founders agreed.

Nine years on, Mirxes now has one clinical product – the world’s first molecular blood test for the early detection of stomach cancer. The company has also finished a trial in China involving 9,400 people. 

In just under a decade, the company has also grown from its trio of co-founders to about 400 employees today. It has a physical presence in places such as Singapore, Malaysia and China, and has conducted sales in over 40 countries. 

In Zhou’s view, the first five years were “building years” for Mirxes. But plans thereafter were disrupted because of the Covid-19 pandemic, during which the company pivoted to producing Covid-19 test kits to help meet the heightened demand for them in Singapore. 

Last year, the company got back on track, he said. Through 2022, it accelerated its pipeline in colorectal and liver cancer tests, and started its “most ambitious effort to date” – a test launched in July last year which can detect up to nine types of cancer. 

This test is still in development, and early access to it is likely to begin in late 2025. “We are currently recruiting 12,000 individuals in Singapore and 10,000 more individuals overseas for the development and validation of this test,” he said. 

Before he co-founded Mirxes, Zhou led a research team at A*Star. His role in Mirxes was his first commercial one, and it required him to learn on the job. 

In the company’s early days, there were a few companies in the local biomedical startup ecosystem, and insufficient venture capital going around, he said. 

“The science was early, and although we were very competent, there (weren’t) any products (in the market). So there were many people who were cautious about whether we could… develop the science, turn it into a product and commercialise it,” he said. 

It took nearly 600 pitches for the company to raise its first US$3 million. It got easier after that. The second funding round brought in US$40 million; US$87 million came in 2021. The company is near the close of yet another funding round, he said.  

Zhou said that this year through 2026 will be the “scaling” years for Mirxes, particularly for its top line and bottom line figures. The company is also looking to expand in the Asia-Pacific this year – particularly in China, as well as Indonesia and the Philippines with their sizeable populations. But Zhou said that the company will be strategic in its expansion plans, even if it is doing well. 

“We’re conscious that managing a global operation is challenging,” he said. “So we’re quite cautious in terms of the markets we expand into. Only when we do well in these markets, will we try to scale the other markets.”