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September 3, 2013

Host: Ted Simons

Cancer Testing

  |   Video
  • HealthTell Inc., a biotech spinout from Arizona State University, has raised $4 million in new funding to help commercialize a new test for lung, breast, prostate and colorectal cancer. The HealthTell diagnostics technology was developed at the ASU Biodesign Institute in part by Dr. Stephen A. Johnston, who will talk about the new test and the funding.
  • Dr. Stephen A. Johnston - ASU Biodesign Institute
Category: Medical/Health   |   Keywords: ASU, HealthTell, cancer, testing,

View Transcript
Ted Simons: HealthTell is a local startup medical company that worked with ASU's Biodesign Institute to develop a test that can detect cancer and more than 30 other illnesses by measuring the body's response to a pathogen instead of attempting to detect the pathogen itself. Dr. Stephen A. Johnston developed the new test. And he joins us right now. Thank you so much for being here. This is a new test for cancer. Give us more here.

Dr. Stephen A. Johnston: Well, our goal has been to have a really simple, inexpensive test that would work for any disease. And we have been working on it for many years to do that. The process is quite simple. You take a drop of blood, literally a drop, and you dilute it 10,000-fold and you put it on a little chip that we manufacture. And what happens is, your antibodies that are in your blood bind to that chip. We wash it off and we look at signature, basically the fingerprint of your antibodies on that signature. And it changes day to day but it also changes coherently if you have a particular disease. So the signature, when you have a cancer, will change versus Alzheimer's.

Ted Simons: This is lung cancer, breast cancer, prostate cancer, colorectal, all the biggies?

Dr. Stephen A. Johnston: We have looked at all of those.

Ted Simons: How do you test the test? How do you know it works?

Dr. Stephen A. Johnston: So fortunately there are many registries where they have collected blood on people who had a particular kind of cancer and people that don't have that cancer. Because this assay is so simple we can go back to those blood collections and say, OK, can we tell the difference in the blood between somebody who has breast cancer and somebody who doesn't have breast cancer, somebody who has lung cancer versus somebody who has breast cancer, and it's a very simple test. We can pretty quickly figure that out.

Ted Simons: Black and white or is there some gray areas?

Dr. Stephen A. Johnston: There are gray areas because cancers have different stages. And some of them are earlier than others. And so for instance when we looked at very early pancreatic cancer, the signature of that looks very different than late-stage pancreatic cancer. Cancer is changing even over time.

Ted Simons: But do both signatures, are they both different from no pancreatic cancer?

Dr. Stephen A. Johnston: Yes.

Ted Simons: So you know something is going on, just not maybe sure what?

Dr. Stephen A. Johnston: Right. And we can figure that out, it just takes longer. We have to look at more samples and look at it more carefully.

Ted Simons: This business of an immuno signature, what are we talking about here?

Dr. Stephen A. Johnston: It's basically what I described. You have about 100 billion antibodies in you at any particular time. And they are changing all the time relative to your health status. And so when you get a cancer, or Alzheimer's, or an infection, one of the first things that happens is that the cells that make those antibodies change their production rates and what they are making. And the chip that we designed is so sensitive it can actually pick that up, those small changes that are taking place, even at early stages of cancer and infection.

Ted Simons: Is it similar to when people get tested for viruses? They find antibodies. If you had chickenpox or mumps when you were a kid, you will have those antibodies with you the rest of your life.

Dr. Stephen A. Johnston: It's the same principles, the same antibodies being tested but in the old ways, we just collected the sum of those and we said, OK, you have antibodies to chicken pox. Now we can spread all of those antibodies out and look at them in their fine detail and basically tell, you have a good protection against chickenpox or you don't have good protection against chickenpox.

Ted Simons: With that in mind can you look at this test and say, you don't have pancreatic cancer or whatever the case may be, but the immuno signature suggests you might or the tendency is there. Does it work that way?

Dr. Stephen A. Johnston: No, it doesn’t. That's more the 23andMe type of assay where you look at the DNA and you say, oh, you have a genetic mutation that makes you more likely to get this cancer. What this would be more than the next stage where you say, maybe I have a propensity for lung cancer, but that doesn't say I will get it or even when I will get it. But you would use this test if it all works the way we plan it, you would use this test to say, OK, now I see that there is the first indication of lung cancer.

Ted Simons: And compare what this test would do with current detection methods.

Dr. Stephen A. Johnston: We have very, very few what are called biomarkers for early cancer detection. So really what we are trying to push this for is that we can take the time point that you would detect a cancer earlier and earlier. We know, from a lot of, for a lot of experiments, that cancer can start 10 or 20 years before it's actually diagnosed. But we don't have those markers yet that we can pick that out. We think these immuno signatures because they are so sensitive may allow us to do that.

Ted Simons: It's interesting you bring that up because there was some debate I think with men's prostate cancer especially regarding a test whether or not you need to know you have it when it could be 20,30,40 years in development, and you could be long gone by the time this becomes a problem. How does that play into all this?

Dr. Stephen A. Johnston: That's a really important question. It plays very prominently in the question. These are called -- it's estimated that for prostate cancer, breast cancer, lung cancer, there's maybe 25 percent of the growth that you won't even call them cancers, growths that are detected by current diagnostic techniques are actually something we shouldn't worry about. They will either self-resolve or they will stay indolent for, stalled for so long that they are not even a concern. So an important aspect for any detection system that's going to detect cancer early is to be able to tell the good guys from the bad guys. And that's an important challenge for us.

Ted Simons: A challenge but can that challenge be met?

Dr. Stephen A. Johnston: We think it can and our preliminary evidence says that that’s certainly a possibility, to tell what is an aggressive cancer from a benign cancer.

Ted Simons: Technology designed at the ASU Biodesign Institute. Give us more information on that.

Dr. Stephen A. Johnston: The institute or the technology?

Ted Simons: The whole process. I was hired about seven years ago by George Post to come over here and invent things that nobody would take a chance on. That's what I did. And the Biodesign Institute was the place to go for doing that, to do way-out ideas and they gave you a running chance to see if you could do it or not. And it's turned out quite well. The ideas that George let me try out that everybody thought was crazy, they look pretty promising right now. This was one of them.

Ted Simons: Was this an idea you had?

Dr. Stephen A. Johnston: Yeah.

Ted Simons: Or idea you researched?

Dr. Stephen A. Johnston: No. It's an idea, it was driven by the concept that we had to revolutionize health care. We can't have, we can't be going on -- I have heard the talk just before this, and the health care act is good in the sense, or bad, depending on your opinion, but it basically redistributes who's taking responsibility for the current system. What we really need to do is fundamentally rethink the health care so we stop being a post symptomatic health care system taking care of people after they get sick and start being presymptomatic so we can give people better costs cheaper. That was our mission, can we get, is there a technology we could invent to allow people to have better health care cheaper, and cheaper is important.

Ted Simons: Indeed.

Dr. Stephen A. Johnston: It wasn't then. We got criticized for saying the word "cheaper." But that was the sole goal. We just set out, I am an inventor, and so I just said, that's the goal. Let's see what we can invent and what we came up with was immuno signatures.

Ted Simons: This is licensed through ASU tech transfer arm? Explain please.

Dr. Stephen A. Johnston: All of the technology that's developed by people within ASU goes through an independent entity that watches out for ASU's intellectual property called AZT. They go out and say here's the technology. We will contact the people that might be invest in it or license it or something. They are basically the technology transfer managers for all of ASU.

Ted Simons: Interesting. So we got this new test now. Is the new test in use?

Dr. Stephen A. Johnston: No. So that's what health care or HealthTell was started for.

Ted Simons: OK.

Dr. Stephen A. Johnston: So we need to, there's an important aspect of that. I briefly went over this chip. Right? The key is that if you are going to monitor people's health on a regular basis, every let's say once every six months or something, you have to be able to manufacture millions if not billions of these chips. So we turned to the Intel-type technology to start manufacturing these chips and just set up a facility in Chandler to manufacture these chips on a large scale.

Ted Simons: Real quickly, one year away? Two years away?

Dr. Stephen A. Johnston: The launch estimate is the beginning of 2015.

Ted Simons: All right. Good luck. Encouraging news and we wish you the best.

Dr. Stephen A. Johnston: Thank you very much.

Rep. Kyrsten Sinema

  |   Video
  • Arizona Democratic Representative Kyrsten Sinema will talk about congressional issues such as immigration reform, student loan debt and veterans’ needs.
  • Kyrsten Sinema - Democratic Representative, Arizona
Category: Immigration   |   Keywords: congress, congressional, immigration, reform, update,

View Transcript
Ted Simons: Good evening and welcome to "Arizona Horizon." I'm Ted Simons. Congress is facing a major decision regarding what President Obama describes as a limited and narrow attack against Syria. Here now to discuss the situation, along with other issues, is Representative Kyrsten Sinema of Arizona's 9th Congressional district. Good to see you again.

Kyrsten Sinema: Ted, it's great to be back with you.

Ted Simons: Let's talk about this because this is front and center, A number one here. The president is considering what he calls a limited, narrow attack. Is this something that the United States should be getting involved in?

Kyrsten Sinema: You know, Ted, I think it’s too early for us to answer this question. I learned about the president's decision actually last weekend when I arrived home from a trip to Afghanistan visiting our troops. So it was a huge surprise to see the president take this position. What I am interested in doing is getting a briefing. I need to be fully briefed from intelligence officials, from the leadership of our military branches, to understand what the president's intention is in this strike, and what the administration defines as a victory. I think it's undisputed that chemical warfare has been used by the Assad regime against the people of Syria. What isn't yet clear is what the United States stands to gain from a security perspective with a limited attack, what that would look like, and, frankly, what that means for U.S. security interests in the short and long term.

Ted Simons: You are talking about repercussions after the bombs fall.

Kyrsten Sinema: We just don't know. As of right now, we are not sure what the president intends to do, what the strike would look like. We are not sure what impact that would have on either the regime or the rebels. As you know, some of the rebels are affiliated with Hezbollah and some are affiliated with Al-Qaeda. We are not sure what it's going to look like. I am reserving judgment until I have had the opportunity to get all the information from a classified briefing. But I do have a lot of questions.

Ted Simons: I was going to say talk to us about those questions and how much information you need. When the president says the U.S. can't ignore people being killed by chemical weapon, the Secretary of State says he can't afford to be spectators to slaughter. You can't just sit there and do nothing. Can you sit there and do nothing?

Kyrsten Sinema: I think the real question is, what are the U.S. security interests in this struggle? Do we win? What does winning look like? What does this mean for the short-term and long term security interests of the United States? Does the regime of Syria present a short-term or long-term threat to the security of our country or allies, particularly countries like Israel? I think it's too soon to answer those questions. And I haven't gotten an answer yet. I am interested in hearing. And so what I am going to be doing this week is listening, both to the administration and to the constituents of district nine, to determine the best course for our community.

Ted Simons: There's a thought out there that says we should be emphasizing prevention as opposed to punitive action. Again, doing nothing would send—the critics say doing nothing would send—the wrong message about American influence and standing by its allies and punishing its foes. I know you are looking for answers and such but are these the kind of things that need to be considered?

Kyrsten Sinema: I think these are the kind of questions that need to be asked and until we have an opportunity for a thorough discussion of all the possibilities, all the outcomes both intended and unintended, we can't really make a decision on this issue. But it's Congress's job now to ask those questions, to get those answers from the administration and to make a decision that's right for our districts, that's right for our country.

Ted Simons: Would you rather see diplomacy exhausted, the stakeholders all given a play, maybe working through the United Nations to indict by way of the international criminal court, doing weapons inspections, maybe stopping the flow of arms, these sorts of things? Do you find yourself geared more toward that than even a narrow and limited strike?

Kyrsten Sinema: You know, I always believe that we’ve got to have all hands on deck, that we shouldn't take any options off the table. What I don't know is which option is the right one for us right now. That's simply because I don't have all the information. So what I have said publicly and what I would hope all representatives would say is, until I have all the information, I don't want to lean one way or the other or make a decision one way or the other. The worst things we could do is jump to a conclusion without having all the information.

Ted Simons: The president says he has all the information and so does the Secretary of State John Kerry. They say they have the information, and that we have to do something and that we should do something and the president was apparently ready to do something until he stepped back and said, all right, Congress, you want to play, let's play. How much emphasis do you put on the president's judgment? John Kerry's judgment?

Kyrsten Sinema: Well, I think the voters of district nine rely on me to make my judgment based on what matters to our district and to our constituents. And with all due respect to other elected leaders, I am representing the people of district nine and that's my sole and primary responsibility. And so what I intend to do in classified briefings is listen to the arguments and listen to the information. But make a judgment that's right for our district. And the only person who can do that is me. I am the elected representative. But it's my job to listen to the community in our district as well as listen to informed military officials at our country.

Ted Simons: What are you hearing from your constituents in your district?

Kyrsten Sinema: I will say that as I mention I came home from Afghanistan on Friday. And as an aside I want to say, Ted, it was absolutely incredible to spend time with our men and women who are serving in the armed services and representing Arizona so proudly. I went to go visit, I thought I would ask them lots of questions about Afghanistan. But all they wanted to do was talk about home and talk about Arizona. We even had a little ASU photo of me with some Sun Devils. So it was wonderful to be with them but to come home and hear from constituents at home, they were saying much of what I was hearing from troops in Afghanistan, which is, be really careful. Think carefully before we go and make an intervention. We don't know what it would look like if ground troops were committed. I am very concerned that we could lead to a commitment of ground troops which I think would put our service members in harm's way.

Ted Simons: It sounds like leadership, that the president informed leadership and certainly Secretary Kerry informed leadership that ground troops would not be involved.

Kyrsten Sinema: That's reassuring. That's reassuring. I think all Americans, most specifically here in district nine, we are tired of seeing our service members in harm's way. Thank goodness in Afghanistan, as the draw down is occurring we are seeing fewer and fewer casualties. We want to make sure that doesn't happen to our service members in other countries.

Ted Simons: Last question on this and it goes back to something I ask often during debates regarding the thought process that goes into this kind of an office. If the majority of folks in your district say, yes or no, but you find yourself saying no or yes, which side do you fall on? What do you do?

Kyrsten Sinema: I think you always have to do what’s in the best interest of your community and country. My hope is that it usually aligns with the popular feelings of your constituency. Ted, you know me, I have taken unpopular positions before and I think it's important we do what's right for the long term safety and security of our country.

Ted Simons: If you get maybe a 55-45 split, and you still think it's either the right thing to do or the wrong thing to do that's the direction you would head?

Kyrsten Sinema: I think the people elect you to certainly reflect their views but to do what you believe is right. And I hope in this case—it’s going to be a very difficult decision—but I want folks to know I am weighing it very carefully, both the opinions of the constituency and the information we will be getting from the administration about the long-term security interests and I intend to make a decision that is hopefully the best for our country.

Ted Simons: Let's get to immigration reform. What are you hearing back there? It sounds like things are crowded there in the house and all sorts of ideas are happening regarding defunding, Affordable Care Act and all sorts of stances being taken. The Senate plan is still there and still there to work with. What are you hearing?

Kyrsten Sinema: Well, I think there's a lot of debate about how immigration will move forward in the house. It's not likely the Senate bill comes to the house. What's more likely is the house takes a certain set of issues regarding immigration and deals with them one by one. And in preparation for that, about a week and a half ago I went and spent a day down at the border meeting with ranchers, meeting with folks who keep our country secure, meeting with border sheriffs and meeting with the folks who live and work on the border, the produce folks, the real estate folks and trying to understand what is actually the feeling on the border and what they need for security and the long-term plans for immigration. I can tell you I learned a lot, Ted. What I am going to do is take that information back to Congress to hopefully inject our conversation in the house with a practical dose of common sense.

Ted Simons: Does it sound, though, it sounds to me like you are saying, what I am hearing from Congressional Republicans as well, that instead of the comprehensive seems to be a pejorative in this debate, but instead of a comprehensive immigration reform plan the house seems to be looking at taking it on piecemeal. Is that something that makes sense to you?

Kyrsten Sinema: That’s right. I am pretty practical as you know, Ted. If we have to do it in little bits and chunks, let’s do it in little bits and chunks. If we do it all in one piece, that’s great. I really feel like we just have to get to yes. The people of Arizona are living in a crisis because of the Federal government's failure to address this immigration issue. We are ground zero for Congress's failure. So my opinion is, whichever way we get to yes, whether it's in one bill or four or five bills, let's just get there. And the method we use to get there is less important than the substance of what we do.

Ted Simons: The pathway to citizenship seems to be a real stumbling point in the house for the Republicans. Is a pathway to citizenship so essential that if it's not included, the whole thing is scuttled?

Kyrsten Sinema: I think the practical reality is that to get a bill through the house and the Senate and to the president's desk, you need both a pathway to citizenship for most, if not all of the folks who are already here, particularly dreamers. But you also need a strong security set that ensures we have a secure border, protected from our enemies in the future. And with both of those components, I think we can find a solution.

Ted Simons: It sounds like the Senate plan does work on that security, and probably more than some had originally thought. And yet we are hearing from folks in the house, one of the leaders there, I forget the committee but the committee is looking at this, saying pathway to citizenship, DOA, don't even start that.

Kyrsten Sinema: That was Representative Goodlatte, who is the chair of the judiciary committee. But I refer you to representative McCaul of Texas. He’s the chair of the Homeland Security committee. He passed a border security bill out of his committee unanimously. Ted, you know not much happens unanimously in the United States Congress. So there is a way to find consensus and I think that Mr. McCaul is on the right track.

Ted Simons: Let's talk about the Affordable Care Act here real quickly. We had Senator Flake on recently and he said that the Affordable Care Act is falling under its own weight even as we speak. Valid?

Kyrsten Sinema: Well, as you may know, I actually published an Op-Ed in the "Arizona Republic" yesterday where I called on Congress and the Federal government to take time to fix portions of the Affordable Care Act. There are portions of the law that are very important that need to be protected. Protecting kids from being banned because of preexisting health conditions, allowing young kids like college kids to stay on their parents' insurance until they are 26, stopping the discrimination against women. Right now women pay more than men for health care. So those things are very important to keep. But there are a lot of stinkers in the law. There are some real problems in the law for businesses, for families who are trying to understand how to navigate the law. So I think we have got to do two things. First, help navigate the law so small businesses and families can figure out what works best for them. Then number two, Congress needs to find some bipartisan solutions to fix some of the problems in the law and make it work.

Ted Simons: I think one of the stinkers that critics of the plan point to I will the idea the penalty for no insurance seems to be as it stands now, in many cases, lower than the premium. That structurally will not hold. A valid point?

Kyrsten Sinema: That is very true. Over time, of course, that penalty gets much higher. What I think would be more effective is to change the way that we manage, for instance, businesses so that businesses can get the information they need, that it's an incentive for them to get health care for their employees and they can afford it. Right now under the law business still can’t afford insurance with the new marketplace. We have to fix that.

Ted Simons: The CBO estimates I think put this thing as being obviously a plus as you get on down the road. But again, according to Senator Flake and critics of the Affordable Care Act the assumptions are all wrong, the numbers they have plugged into that equation are all wrong. Certainly some of the ideas moving forward would not be what those equations are. Can you trust the CBO numbers? Can you trust the fact that once we start on this road, we are not going to be begging and itching to get off it in a few years?

Kyrsten Sinema: You know, I don't know whether or not the CBO numbers can be trust order not. I have only been in Congress about eight months, so I’m not an expert on the CBO. But what I do know is this. That if something isn't working it's Congress's responsibility to fix it. It's our job to take a look at the law, fix the parts that don't work, get rid of things that aren't great, add new stuff if we need to and make adjustments as we go along. And the truth is, Ted, that's what Congress has been doing for generations. Every time we pass a big piece of legislation we have to make fixes to it along the way. And that's Congress's primary duty when it comes to passing and changing legislation.

Ted Simons: Is Congress ready, though, to make fixes or is Congress just, again, itching to scuttle the whole thing?

Kyrsten Sinema: I think it depends on who you ask, Ted. I am a bipartisan co-sponsor of three different bills to make fixes to the Affordable Care Act. Each those bills purely bipartisan.

Ted Simons: Very quickly, what are those ideas?

Kyrsten Sinema: Let me give you one. One is to change the way the taxation works on medical devices. It actually doesn't raise that much money. It's a bad idea. And it hurts technological innovation and most importantly hurts Arizona companies. We want to change that and get rid of it. We also want to get rid of this innovation board that seems to kind of have its own ability to change aspects of the law outside of Congressional approval. That doesn't work. That's not the way it should be. So I have sponsored a bill that helps get rid of that. Those are a couple of examples.

Ted Simons: Are you getting Democrats on board with those? I imagine Republicans would be eager to say no to anything.

Kyrsten Sinema: They are bipartisan.

Ted Simons: So Democrats as well are saying we got to fix this?

Kyrsten Sinema: Absolutely. Anyone who functions from a common sense perspective recognizes that eliminating an entire law is not super likely but what is possible to fix it and make it workable.

Ted Simons: Good to see you again.

Kyrsten Sinema: Thanks, Ted.