Early detection of lung cancer

Cizzle Biotechnology Ltd (Cizzle) was identified by Bould Opportunities (Bould) as its preferred target for a reverse takeover. Cizzle is a spin-out from the University of York to exploit the biomarker, variant CIZ1b, for early detection of different forms of lung cancer. The presence of nodules often detected on chest scans is suspicious, but not usually a sign of lung disease. Therefore, there is high medical need for a simple blood test to be used alongside a positive chest scan that allows early detection of lung cancer and significantly reduces the number of false positives. The company has raised £2.2m to develop its biomarker test through to CE marking.

• Strategy: Cizzle is a diagnostic company progressing a biomarker companion diagnostic assay that aims to deliver a simple blood test for lung cancer which can pick up the disease earlier to improve the chances of survival, and to greatly reduce the need for unnecessary follow-up tests and tissue biopsies.
• Variant CIZ1b: CIZ1 is a naturally occurring cell nuclear protein that promotes DNA replication. Cizzle has shown that variant CIZ1b is prevalent in lung tumours. The variant protein can be detected in the blood at an early stage in lung cancer patients, when the disease still bears a good prognosis.
• The opportunity: Lung cancer is generally first identified from a chest scan. Patients with suspicious scans then undergo further tests. However, these often result in false positives that require two-year follow-up. Eliminating 50% of these could help patients and generate substantial cost savings for healthcare providers.
• Risks: Cizzle has a proven prototype test. To move this to a commercial product with CE marking, the company needs to produce a monoclonal antibody, optimise the reagents and buffer environment, and validate the test with a retrospective trial. The aim is to achieve this within two years.
• Investment summary: The EV of Cizzle, at the time of Admission, will be £24.4m. A group of four close peers, all working in the field of specialist diagnostics/liquid biopsies, mostly in the field of oncology, currently have an average EV of £109.2m, but are at a later stage of development and/or involved in COVID-19 testing. This suggests that Cizzle is trading at a discount of 78% to its peers, reflecting its earlier stage of development, with considerable upside potential.