Neurosurgery is on the cusp of a revolution; the leader of Indianapolis-based NICO Corp. likens it to the transformation that swept through cardiology 20 years ago. The brain is the “final frontier” of human organs to have a minimally invasive approach for surgery, and NICO says it’s leading the charge on multiple fronts. Boosted by a recent $12.5 million round of funding, NICO is expanding on 14 years of selling product by adding another market to its focus: precision medicine for brain cancers.
NICO says it’s the first company in the world to develop and patent technologies “to create an entirely new minimally invasive surgical market in neurosurgery” to reach abnormalities in the brain, namely stroke or brain tumors. NICO is led by the same team that founded Indiana-based startup Suros Surgical Systems, which was sold to Hologic, Inc. in 2006 for $238 million.
NICO’s story began with a device called BrainPath, which is about the width of a Sharpie marker and has a pointed tip to slide between the folds of the brain to preserve critical tissue, rather than cutting through the brain. The company has also created a handful of other devices that illuminate and remove tumors for minimally invasive surgery.
Beyond just removing the tumor, NICO is now investing heavily in its newest mission to blaze a trail in brain cancer research and treatment. In cancer, precision medicine—also known as personalized medicine—analyzes the genetics of an individual’s tumor to find what drug or treatment will be most effective for that person’s unique tumor. It’s to led to great advancements in breast cancer, for example, but personalized medicine has yet to make waves in brain cancer.
Glioblastoma (GBM) is the most aggressive kind of brain tumor in which patients typically survive only 15 months. NICO Chief Executive Officer Jim Pearson says in the last 50 years, the medical field has only extended patients’ survival by two to three months.
“The patient need is huge,” says Pearson. “[The medical field] has put 50 years of work—billions of dollars, tons of scientists and academics—into GBM, and we just haven’t moved the needle.”
NICO says much of that stagnancy is because surgeons have been unable to obtain quality tissue samples of the tumor so the genetics can be analyzed to find the most effective treatment. Pearson says NICO’s Myriad tissue resection device and Automated Preservation System clears this major hurdle by giving researchers and pharmaceutical companies “a better starting point.”
“We put brain tumors on life support; immediately when the brain tumor comes out of the patient’s head, we keep the molecular information alive—the RNA and the proteomics—and we keep the cells very viable; that is so critical because these things die in as little as 10 minutes,” says Pearson. “We’re the first company in the world to automate the biological preservation of the tissue immediately in the operating room—not at an outside biobank that eventually gets the material hours or a day later. And that’s critical.”
Keeping the tissue alive means it’s in the best condition to be studied. Pearson says rather than the neurosurgeon “fuddling around on the back table” with a tissue sample, the system automates the process, starting with a tiny “scissor and sucker” that sucks the tissue into an area where it’s chilled, buffered continuously with a preservation fluid and kept alive “without anyone putting their hands on it.”
Noting that keeping the molecular integrity intact is the “building block” of personalized treatments, NICO has inked a partnership with precision oncology company Kiyatec, based in South Carolina. Kiyatec tests the tissue to determine which drug will work best on the tumor.
“We supply better tissue, so Kiyatec can run a better, more accurate and more determinate test,” says Pearson. “They let the doctor know within seven days, ‘Drug A will work, but not drug B.’ This is the basis of precision medicine.”
NICO is also less than six months away from getting trial results for the use of BrainPath to treat hemorrhagic stroke, the most deadly and debilitating form of stroke. NICO expects positive results, which Pearson says would make it “the only company in the world to have ever had a positive trial for [hemorrhagic stroke].”
“We can’t change GBM and hemorrhagic stroke overnight, but what’s truly exciting is we’re on the precipice of significant change. Neurosurgery, neuro-oncology and stroke—they’re where cardiology was 20 years ago. Cardio went through a huge revolution; we’re right there on the cusp in neurosurgery,” says Pearson. “The work we’re doing is so important; in hemorrhagic stroke and tumors, it opens up a world of possibilities that can have a huge impact on patients’ lives.”