Following diagnostic procedures and the decision to use CATE, the patient will receive a soluble formulation of CATE in an intravenous injection. This is a quick and easy step for both the patient and the doctor.

CATE distributes throughout the body and specifically populates the tumor tissue. Only in this special microenvironment, rich in nutrients and hidden from the immune system, CATE can grow to a high cell density. [1][2]

To pass Checkpoint 1, cell density of the bacteria in the tumor has to be high enough to kill it. Once this has been achieved, CATE will start to produce an Anti-Cancer Toxin. However, the toxin will not be released yet. It will reside in CATE until the second checkpoint has been passed. At the same time, CATE will also produce an MRI Contrast Agent. This will allow the doctor to confirm through an MRI scan that the Toxin is ready and the bacteria have indeed colonized the correct location. This additional security step is unique to our bacterial cancer therapy with CATE. Neither conventional cancer treatments that include systemically administered toxic compounds, nor modern targeted therapies with engineered immune cells have the advantage of combining an internal molecular tumor-recognition with the ability to externally verify and manipulate the treatment.

Immediately after examining the MRI scan, the doctor can apply focused ultrasound specifically to the tumor site. Focused ultrasound is an emerging medical technology that allows for high-energy sound waves outside of the audible spectrum (the same ones used by bats for navigation) to transmit their energy to a specific location on the inside of the body. [4] This results in a temperature increase in a narrowly defined area of the tumor.

After successfully going through Checkpoint 2, CATE is designed to produce a special protein that originates from bacteria-killing phages. This protein interferes with the bacterial cell wall synthesis which leads to pore formation and ultimately, the breakdown of CATE. This way, the previously accumulated Anti-Cancer Toxin is released to the tumor tissue.

After the Anti-Cancer Toxin gets released, it enters the malignant cells. Once inside, it interferes with the cell cycle through multiple mechanisms, which include stabilization of a tumor suppresor protein and blocking of the transduction of growth signals. This interference inhibits the growth of cancer cells and ultimately results in their death. [5][6] With this, CATE’s mission is accomplished.