When Oscar-winning actress Angelina Jolie revealed she carried the BRCA1 gene mutation for breast cancer, her decision to undergo preventive surgery sparked a global conversation about genetic screening. Her op-ed, “My medical choice” in The New York Times, called for better access to life-saving genomic testing.
A decade later, the need for precision diagnostics remains just as urgent–especially in cancer care. That’s where MSInsight comes in. The Paris-based startup has developed MSIcare, a patented screening technology that detects Microsatellite Instability (MSI)—a key biomarker that signals whether a tumor will respond to immunotherapy. Unlike traditional diagnostics, which can miss MSI-positive cases, MSIcare identifies them with near-perfect accuracy, potentially changing patient outcomes.
Backed by a €1.6 million seed round from French business angels, Bpifrance, and biotech crowdfunding platform Capital Cell, MSInsight is now gearing up to bring its breakthrough to market.
I checked in with MSInsight’s CEO, oncologist Dr Arnaud Cutivet to learn more about microsatellite instability and how this cancer causing DNA anomaly could also be the key to unlocking more precise and effective treatments for many cancer patients.
What is MSI?
MSI occurs when a DNA repair system, known as the “Mismatch Repair System,” fails during DNA replication. This defect allows faulty DNA sequences to persist, potentially leading to the development of tumors.
MSI cancers make up around 4% of all cancers and are most commonly found in the colon, stomach, and endometrium, where they represent 10–30% of cases.
Colorectal cancer, in particular, is the fourth most common cancer with 1.8 million new cases worldwide and 45,000 cases in France annually. MSI is present in around 10-15% of these cases.
The silver lining is that MSI tumors respond particularly well to certain immunotherapies. Identifying these tumors early can significantly improve treatment outcomes and patient prognosis.
Dr. Cutivet explained: “MSI cancer cells are present in 4% of cancers, especially colorectal, stomach, and endometrial cancers. Early detection, particularly in colorectal cancer, means we can use immunotherapy effectively, potentially saving lives.”
So, how effective is immunotherapy for MSI cancers?
"The statistics are promising for MSI cancer patients with unprecedented response rates and long-term survival benefits." he confirmed.
How MSInsight Does Precision Screening
Founded in 2022 by a team of academics, researchers, and computer scientists, MSInsight is reshaping MSI cancer diagnostics with its patented tool, MSIcare.
Built on two decades of groundbreaking research spearheaded by Inserm and Professor Alex Duval, Assistance Publique des Hôpitaux de Paris, and the Sorbonne University, the company aims to revolutionize how MSI cancers are detected.
MSIcare combines next-generation sequencing (NGS) with advanced bioinformatics algorithms developed by MSInsight’s Head of Bioinformatics Toky Ratovomanana. The tool identifies errors in the repeated tandem sequences in the patient’s DNA (microsatellites) that characterize genomic instability, thereby quantifying microsatellite instability (MSI).
“We analyze DNA from blood or tumor samples, translating it with computer programs into a written code, unique to each person,” said Cutivet. “Using this code, our algorithm then calculates MSI levels, and if they exceed a certain level, the tumor is classified as Microsatellite unstable.”
Drawing from 30 years of clinical data from Parisian hospitals, MSIcare has already proven near-total accuracy in colorectal cancer. “We’ve shown near 100% accuracy in colorectal cancer,” Cutivet added. “Now, in cooperation with key opinion leaders in the field, we’re testing its superiority across other tumor types, analyzing thousands of patient samples.”
Why MSI Screening Matters
MSI biomarkers, like MSIcare, are pivotal in guiding immunotherapy decisions. Accurate, large-scale detection can mean the difference between effective treatment and missed opportunities. Current methods, such as PCR or existing genomic data interpretation solutions, have high error rates and are not adapted to all kinds of tumors, causing false negatives, delays, and unnecessary costs.
“A few years ago, immunotherapy was a last resort,” Cutivet said. “Now, it’s a first-line treatment. In some cases, where the tumor is caught early, it can even avoid surgery, improving outcomes and cutting healthcare costs.”
For MSI screening to be effective, precision is key. MSInsight’s approach, combining sequencing with proprietary software and advanced bioinformatics, ensures near 100% accuracy.
Beyond diagnosis, MSI screening identifies individuals at genetic risk of developing MSI-related cancers. “30% of MSI-positive patients are genetically predisposed and may develop cancer at a younger age,” explained Cutivet. “Early detection allows for proactive monitoring and prevention.”
Bringing Innovation to Market
Turning breakthrough technology into a widely available diagnostic tool is no small feat. Unlike academic research, bringing medical innovations to market requires funding, regulatory approval, and large-scale development - challenges that traditional labs can’t manage.
The first challenge is funding. Moving from research to real-world application demands a team of engineers, bioinformaticians, and compliance experts. Without financial backing, scaling the technology is impossible.
Next comes regulatory approval. In Europe, diagnostic tests must meet strict certification standards before clinical use. Achieving CE IVD Marking requires proving compliance with cybersecurity, quality control, and patient safety—no small task.
Then, the long R&D journey begins. Validating a diagnostic tool requires extensive patient data to refine the algorithm and ensure reliability across various cancer types. This process has been a priority since day one.
To tackle these hurdles, the team made a strategic decision: build a company to bring this technology to life.
A SaaS-Driven Approach to Transforming MSI Detection
MSInsight has embraced a SaaS (Software-as-a-Service) model, enabling laboratories to seamlessly integrate MSI detection into their workflows. The solution is currently being tested in select labs across France, Germany, and the U.S. The next phase is expanding through pilot programs in hospitals with sequencing capabilities and offering real-time experimentation tools.
To drive adoption and impact, MSInsight has structured its business model around three key approaches:
- Direct Sales to Hospitals: MSInsight provides hospitals with direct access to its MSI detection technology, integrating it into existing diagnostic workflows to improve cancer detection and treatment decision-making.
- Licensing Agreements with Genomic Service Providers. Many genomic service providers, such as those offering cancer mutation analysis or rare disease testing, lack MSI detection. MSInsight’s licensing model allows these companies to expand their offerings by incorporating its technology.
- Biopharma Services Beyond diagnostics, MSInsight can support biopharma companies by integrating MSI detection into drug development and clinical trials. This enables pharma companies to better select patients for immunotherapies and targeted treatments, improving success rates and accelerating drug approvals.
Navigating Market Priorities
“While the U.S. remains a key market, European regulatory approval is our focus for now,” said Cutivet.
The MSI detection market is currently dominated by U.S. giants, like Foundation Medicine, which rely on proprietary algorithms. However, their approaches tend to be rigid, with fixed diagnostic protocols that lack flexibility. In contrast, MSInsight is leading the way with a more adaptable, real-time SaaS solution that can be tailored to different tumor types.
“We’re expanding our technology to ensure the highest accuracy, adjusting diagnostics to each tumor’s unique characteristics while pushing the boundaries of MSI diagnostics, making sure our technology is both robust and scalable,” he said.
Paving the Path Towards Precision Oncology
MSInsight has set its sights on becoming a leader in MSI diagnostics, aiming to cover the whole of the MSI-related patient journey and contribute to the evolution of precision oncology.
Looking to the future, Dr. Cutivet sees personalized medicine as the next frontier. Beyond identifying MSI, the company is working on predicting which patients will respond best to immunotherapy.
“Our next focus will be on predicting treatment responses for metastatic colorectal cancer patients,” explained Dr. Cutivet. “This will provide oncologists with valuable insights and help guide their decisions.”
With its innovative approach and clear vision, MSInsight is positioning itself at the forefront of cancer diagnostics. As the potential for precision oncology continues to grow, one must ask: Could this technology be the key to revolutionizing how we detect and treat cancer in the future?
