The Second Part: Promoting Social Implementation of Genome Medicine with Information Technology, Xcoo

The Future Envisioned by Xcoo

In a two-part series, I introduce the technology of Xcoo, Inc. (referred to below as “Xcoo”), which develops and operates “Chrovis,” a total solution for genome and bioinformatics analysis. In the second part, I will continue our interview with Dr. Kunihiro Nishimura, CEO of Xcoo.

Q3. Could you tell us what makes Xcoo different from other companies regarding technology, services, and staff?
Dr. Nishimura: In terms of our staff, more than half of our staff, including myself, have backgrounds in information technology and engineering. Therefore, our strength lies in our ability to incorporate cutting-edge information technology, use it appropriately, and build useful systems in clinical practice. Since we can implement algorithms from scratch, we can be flexible in our responses and applications and keep up with the daily progress in fields such as genome medicine.

One of the services we are currently providing is a service to help physicians search and find treatment information on cancer gene panel tests. The cancer gene panel test can detect gene variants that are occurring in cancer. We will find information on whether the gene variant is pathogenic, involved in cancer, or a target for treatment, and if so, whether there is an approved drug or a clinical trial.  Once the information has been obtained, an expert panel is convened to determine a treatment strategy. The treatment plan will be discussed by the expert panel. We are trying to reduce the time and effort required by doctors to search databases by providing a service that almost automates the process of finding such information. We believe that the concept of “automation” is unique.

Q4. Can you tell us about your vision for the future?
Dr. Nishimura: We have just raised 700 million yen in July 2022 and are planning to expand our business. Cancer genome medicine has started nationwide but has not yet been completely equalized. One of the reasons for this is that physicians have to bear a lot of workloads, and we believe that our service can contribute to alleviating that burden. For this reason, we are focusing on recruiting engineers as well as physicians.

Also, depending on the COVID-19 pandemic, we would like to expand our business to Southeast Asia. From a genomic point of view, Japanese and Southeast Asians are close, and we can make use of the knowledge of genome medicine in Japan.

Q5. You have provided tools for 【automatic analysis of genome mutations, additional interpretation of gene/protein displacement, and annotation of knowledge databases】 to researchers with “Chrovis.” And now, why have you started to appeal to patients and support groups as well, and what were you conscious of in developing the platform?
Dr. Nishimura: Xcoo, Inc. ( https://xcoo.co.jp ) and ASrid (https://asrid.org ), a non-profit corporation, are different organizations with different activities, so I would like to answer your question in a way that takes that into account.

Currently, “Chrovis” is being developed as software for genome medicine, and as a service using “Chrovis,” we are providing annotation services for cancer gene panel tests on behalf of medical institutions. The service involves collecting and summarizing information related to gene variants under the direction of physicians. As part of this service, we also compile information for physicians, but we also compile information for patients. In other words, we create explanatory aids for patients. This is unique in that we create patient information aids.

After the cancer gene panel test is performed and the expert panel decides the treatment plan, the attending physician explains the results to the patient in question. At that time, we prepared these materials in the belief that explanatory aids using illustrations and other materials would make it easier for the attending physician to explain the results and for the patient to understand them. Specifically, physicians provide general explanations about the relationship between cancer and genes, cancer gene panel tests, molecularly targeted drugs, immune checkpoint inhibitors, and so forth in the form of illustrations and text. After that, when the patient's genetic test results show actionable gene variants that could be the target of a drug, we illustrate a pathway diagram of the gene and create an explanatory aid.

In addition to Xcoo, I am involved in ASrid, a non-profit organization, as an intermediary corporation for rare and intractable diseases. Based on the phrase “to patients, for patients, beside patients,” ASrid is working to connect patients, patients’ families, and patient organizations with industry, government, and academia, to distribute information and conduct research. In these activities, we have the opportunity to meet patients and their families, and we are conscious of the need to make our services useful to them in our activities at Xcoo as well.

Q6. What, if any, differences did you make in the development process and the final product from those for researchers?

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