11 Dec TomoTherapy sees sustained market advantage
Madison, Wis. – Fred Robertson doesn’t pretend to be a fortune teller, but he believes his company, TomoTherapy, will be setting the standard in radiation therapy for some time to come.
Robertson, chief executive officer of TomoTherapy, exudes confidence that the Hi-Art System, the company’s radiation therapy platform, will continue to be a competitive differentiator. Thus far, almost 250,000 patient fractions, or incremental treatments, have been delivered worldwide on the Hi-Art, but the key distinction is that clinicians can use the images of every treatment fraction to evaluate patient progress.
Apparently, now it’s time to tell the story to a wider audience because TomoTherapy has decided to brand its adaptive therapy. At the recent annual meeting of the American Society for Therapeutic Radiology and Oncology, the company showcased its “CTrue” marketing message, which is an attempt to articulate the clinical advantages of CT scanning with the intensity modulated, or targeted, radiation delivery enabled by the Hi-Art.
The technology, developed at the University of Wisconsin-Madison and patented through the Wisconsin Alumni Research Foundation, promises consistent positioning accuracy no matter what the patient’s shape, size, or position. This enables clinicians to pinpoint the location of the tumor and healthy structures, and deliver a targeted and accurate dosage – if necessary, with every treatment fraction.
Robertson’s vision of medical imaging actually is based on the present because next generation software products will be made possible by the existing hardware platform. In Robertson’s view, its components arrived in an illogical order.
“Image-guided radiotherapy probably should have been developed before intensity modulated radiotherapy,” he said. “Carefully shaping a radiation beam with IMRT or intensity modulated radiotherapy is only a piece of the puzzle. It is just as important to know where you are delivering that beam as it is to be able to shape the beam to conform to the tumor.”
That hardware platform establishes a CT scanning base that should enable a host of additional software applications. Today, healthcare facilities use the Hi-Art to deliver dosage in a treatment plan and adapt therapies as the size and the position of the tumor changes, and as the size of the patient changes during the course of therapy.
“Adaptive radiotherapy is all about maintaining accuracy and precision through the whole course of treatment,” said Thomas Mackie, one of the company’s scientific founders.
At the moment, this is accomplished in an offline environment with planned adaptive software. As part of TomoTherapy’s future roadmap, Robertson said clinicians will be able to conduct online adaptive therapy with the same ability to change treatment on a daily or even a per-fraction basis, a capability that is complemented by the system’s integrated database.
The image-guided radiotherapy system is capable of generating one or two gigabytes of information per patient, and the next-generation software, which involves real-time tracking and verification, could be even more prolific.
“That is something that the CTrue platform enables – future enhancement of the current product,” Robertson said.
The number of future software upgrades is anyone’s guess, but there is little doubt in Robertson’s mind that they will be applied in a growing number of healthcare settings. With its products already sold in 14 countries, TomoTherapy expects its revenue to grow by 80 percent in 2006. That would bring the company to the $130 million annual revenue mark with 500 employees, and new markets in underserved areas hold intriguing possibilities.
The markets that are most appealing also happen to be in two of the world’s fastest-growing economies – India and China. According to Robertson, the radiation oncology market is in varying stages of maturity, and one of the key metrics is the number of linear accelerators, devices widely used in radiotherapy, per million people. That number is 13 in the United States, but it’s less than one in India and China, which have much larger populations.
In contrast, about 50 percent of the cancers in the United States are treated with radiation therapy as a primary mode of therapy or in combination with chemotherapy, and Roberson believes that India and China are poised to ramp up their technology investments. “Those markets are vastly underserved by radiation therapy as a modality for cancer treatment,” he noted.
Other potential new markets include Eastern Europe and the Middle East, particularly stable countries with stable governments like the United Arab Emirates and Kuwait.
Wherever growth occurs, it could very well be financed without a public splash. TomoTherapy, venture-funded to the tune of $42 million and situated in a new and expanded facility, has stayed away from the capital markets by maintaining modest profitability and positive cash flow. It has witnessed the growing demands on public counterparts and thus far has avoided placing itself in the same quarterly pressure cooker.
The company hierarchy, which includes Robertson, Mackie, and co-scientific founder Paul Reckwerdt, keeps track of the capital markets in case issuing an IPO becomes more attractive and necessary. For the time being, remaining private enables them to focus on long-term planning.
“We’re enjoying being private,” Robertson stated. “It allows us to focus on continuing to develop marketability and to take a long-range view of what’s right for our customers and what’s right for the company without worrying about the pressures of Wall Street.”
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