for prostate cancer patients. It measured “acute” side effects in the first two months after treatment, but it didn’t have a long-term follow-up. It didn’t randomly assign patients to the Calypso system or standard radiation, because it would be too difficult to recruit patients if they knew they had a 50-50 chance of getting traditional treatment, says Lisa Levine, Calypso’s senior director of clinical and pre-market regulatory affairs. The study also didn’t ask whether patients on the Calypso system had their cancer stay in remission any longer—another important question that’s difficult to answer, because of the time and expense involved, Levine says.
Still, the study offers some important medical evidence and intriguing fodder for future studies, Sandler says. Patients in the Calypso study got high-intensity beams of radiation that were more narrowly focused on the prostate gland than traditional methods can allow, Sandler says. Essentially, the doctors know the prostate is going to move while the patient is getting radiation therapy. Since the average prostate is about 4 centimeters in diameter, doctors have traditionally crafted a 6-centimeter-wide beam of radiation to account for their margin of error, and make sure they hit the cancer even while the gland moves. That wider beam, however, ensures that at least some healthy tissue nearby is going to get hit by radiation. The Calypso system gives doctors enough confidence to narrow down the width of the radiation beam to 4.6 centimeters, Sandler says, which means more of the patient’s healthy tissue is spared.
This finding has obvious importance to Calypso as a business. The company raised $50 million in venture capital last September—the Northwest’s biggest venture round of 2009—to help advance its commercial push in the U.S. and Europe. The company is privately held and doesn’t disclose its sales, but it says it now has “almost 100” of its systems installed in U.S. medical centers, up from about 75 last March. More importantly, Calypso now has about three-fourths of all regional Medicare units agreeing to reimburse hospitals for the technology, which is “significant progress” from a year ago, says CEO Eric Meier.
The company, which employs about 150 people, isn’t yet profitable, and is still expected to operate in the red in 2010, Meier says.
“We expect this to add some additional tailwind to our business,” Meier says. “The payers often ask, ‘What’s the clinical benefit of the Calypso system?’ Now, we can say, ‘Here you go.’ They really want to know if this is good medicine, and cost-effective medicine.”
Calypso has been focused throughout its history on prostate cancer, but the basic principle of the technology can be applied to many other types of tumors that are treated with radiation. Calypso hopes to run more studies to show its system can work for tumors of the pancreas and lungs, Meier says.
Researchers are excited about the possibility of using the system for other tumor types, Sandler says, but also about potentially changing the way people get radiation treatment for prostate cancer. One school of thought says that the high-intensity, more narrowly focused radiation from the Calypso system might make it possible for patients to complete their course of treatment in just one or two weeks. The current system is inconvenient for patients, who need to come in to the hospital every weekday for eight weeks, so shortening the duration could be a big advantage in convenience for patients and doctors, Sandler says.
Now that almost 100 of the systems are installed in the U.S., it’s also a safe bet that doctors are going to propose more and more experiments to see how they can best use it.
“Once the technology is installed in the hospital, most of the cost has been borne,” Sandler says. “It’s so easy, you might as well use it more and more if you can.”
