Japan: Poised For The Next Phase Of Growth

In early 2024, the World Health Organization predicted that by 2050 there will be more than 35 million new cancer cases worldwide, an increase of 77% from 20 million in 2022. In Japan, doctors and engineers are harnessing artificial intelligence (AI) and other technologies to help meet a massive demand for tools that can help diagnose and treat cancer and related diseases. Two innovative medical startups in Tokyo are commercializing their innovations to improve the health of people everywhere.

Using AI to Spot Early Signs of Cancer

Mainly because they are detected too late, gastrointestinal (GI) cancers account for the biggest cause of cancer mortality in Japan and worldwide. But what if AI could doublecheck gastroscopy images and pick up any missed problem spots? That’s exactly what AI Medical Service Inc.’s gastroAI model-G does. It’s an AI system that views gastroscopy imagery in real time along with doctors, and makes suggestions about examining potential areas of concern. If it detects a problem spot, within seconds the software highlights the area and displays a warning notice: “Consider biopsy.”

“Endoscopic examination is basically an image-recognition process,” says Tada Tomohiro, CEO of AI Medical Service. “The system acts like an assistant, asking the doctor to double-check potential problem areas.”

In 2016, Tada began applying AI tools to endoscopic medicine. He trained a deep-learning AI system collecting about 200,000 high-definition GI medicine videos and developed what he describes as the world’s first AI system for early gastric cancer and esophageal cancer detection. In 2017, Tada founded AI Medical Service and later established subsidiaries in the U.S. and Singapore.

AI Medical Service’s diagnostic support system has been approved by regulators in Japan, Brazil, and Singapore, and the company has raised some 14.5 billion yen (US$93.4 million) in funding from venture capital firms and government subsidies. Tada is now focused on rolling out his product in Singapore, updating the system along with the evolution of AI, getting approval from U.S. regulators and targeting other forms of cancer for AI detection, even as he continues his clinical work.

“Regardless of whether I am working as a doctor, clinic director or a startup CEO, my goal does not change,” says Tada. “My motivation is to improve medical practice. Ultimately, we want to reduce the rate of missed cancer detection to zero.”

Bringing a Future Full of Hope to Pancreatic Cancer Patients

Across town at Tokyo Medical University Hospital, a cancer patient lies down while a cone-shaped device on a robotic arm is positioned over his abdomen. The device delivers ultrasound energy to the patient’s pancreas and generates localized heat of up to 100 degrees Celsius that destroys cancer cells in the organ. Other types of ultrasound waves allow doctors to monitor exactly the location of the heated region. The procedure is minimally invasive, does not involve any surgery or anesthesia, and only lasts about half an hour.

This technique employs high-intensity focused ultrasound (HIFU). In conventional radiotherapy, radiation damages both cancer cells and the surrounding healthy cells that it passes through. In contrast, HIFU waves can be focused on a small region inside the body and do not damage the healthy cells they pass through. Clinicians in Japan are now hoping HIFU will become a standard treatment for pancreatic cancer, one of the deadliest of all cancers and one that recurs often.

“The pancreas is resistant to radiation, so it requires high doses during radiotherapy, which can involve daily sessions for six weeks,” says Satoh Tohru, CEO of SONIRE Therapeutics Inc. “With SONIRE’s HIFU, patients are expected to be treated with only two sessions on an outpatient basis.”

“With high-intensity focused ultrasound, patients are expected to be treated with only two sessions on an outpatient basis,”

says Satoh Tohru, CEO of SONIRE Therapeutics Inc.

The unique part about SONIRE’s technology is that it makes use of cavitation. Often seen around underwater propellers, cavitation is the formation of gas bubbles in a liquid due to pressure changes. Using cavitation allows doctors to precisely visualize the treatment region to ensure effective treatment and increase heating efficiency, which shortens treatment time.

Results suggest HIFU can be effective when used with conventional treatment. The median survival time of patients with inoperable pancreatic cancer after treatment with chemotherapy alone was 288 days, but when combined with HIFU it was 648 days, according to a 2021 study in the journal Current Oncology.

With its research and clinical partners, SONIRE is now conducting the world’s first randomized, controlled trial of HIFU therapy for pancreatic cancer. The study at six hospitals across Japan will follow the survival outcomes of 90 patients with inoperable pancreatic cancer, with 30 undergoing chemotherapy alone and 60 undergoing chemotherapy and HIFU therapy.

“We want to offer a more effective and safer cancer treatment to as many patients as possible as soon as possible,” says Satoh. “We want to go beyond the boundaries between pharmaceuticals and medical devices,  and one way to do this is through HIFU treatment for cancer patients.”

Note: All Japanese names in this article are given in the traditional Japanese order, with surname first.

To learn more about AI Medical Service Inc.: en.ai-ms.com

To learn more about SONIRE Therapeutics Inc.: www.sonire-therapeutics.com/en/

What we now call Kikkoman Corporation has been doing business in one form or another for over 350 years. It grew steadily at first, as a well- respected business selling soy sauce (shoyu) to Japanese households. It  has since evolved into a global success story and become the focus of business school case studies.

There are a dozen good reasons behind the firm’s success but only one constant factor drives the company’s steady growth—even if its visionary leader, Honorary CEO and Chairman of the Board, Yuzaburo Mogi, would be the first to deny it.

Returning to Japan in the 1960s with an MBA from Columbia University, Mogi realized that if Kikkoman remained confined to its domestic market, it would eventually hit a growth ceiling. He proposed a radical idea: expand the business overseas.

In time, he convinced the management to build a factory in Wisconsin. That was back in the early 1970s, and Mogi has had a steady hand on the tiller of Kikkoman’s global growth ever since. Mogi says, with his characteristic wide grin, “Kikkoman is now sold in over 100 countries, and overseas business accounts for over 70% of our sales and over 80% of our profits.”

Globalization Done Right

“In the past few years, we marked the 50th anniversary of that first plant in the U.S., the 40th anniversary of our Singapore facility, and the 25th anniversaries of both our European and California plants,” Mogi says. In total, the company has eight overseas production plants and a ninth under construction. Surprisingly, the newest facility is only a few dozen miles from the original plant in Wisconsin.

“We always look to hedge risk,” Mogi says. “Building in diverse places can reduce risk, but it also increases costs. We would need new suppliers and supply routes, new business partners, and a new workforce in an area where we have no established presence. Of course, there are also risks in concentrating our facilities in the same area, but the upside is compelling: we can benefit from existing sources of raw materials, established supply chains, existing business partners and a strong local reputation. The people of Wisconsin have come to trust us over the past 50 years. In the end, concentrating our facilities in one area made the most economic sense,” he adds.

Talent: The Most Important Asset

From his many decades in management, Mogi has learned to focus on attracting and retaining the best possible talent to cope with upcoming changes in business and the economy. He is outspoken about the qualities executives need for the future.

“Tomorrow’s leaders need multi-cultural experience. They need to understand other cultures, learn language and thinking skills, and they also need business skills, like sales and marketing. Overseas, university graduates go on to business school, where they can pick up real business knowledge in two years. Japanese universities have not traditionally focused on practical business skills, so the companies have to teach new hires everything,” Mogi says. “Yes, Japan is changing, but it is changing slowly.”

“Companies are realizing that in order to stay globally competitive they need employees who have useful skills and good ideas, regardless of their age.”

– Yuzaburo Mogi, Honorary CEO and Chairman of the Board of Kikkoman Corporation

Mogi adds that Japanese companies must change their basic HR system, which rewards age more than skills. “The seniority system is under tremendous strain now. Companies are realizing that in order to stay globally competitive they need employees who have useful skills and good ideas, regardless of their age. They need to promote people who are more capable, not just those who are older,” he says.

Tomorrow’s Blue Oceans

What does Mogi see in the future for Kikkoman? With nine production plants serving global markets will there still be room to grow?

“Absolutely!” he replies excitedly. “There is still lots of room for growth in Europe and in Asia. In time, we plan to strengthen our production systems in both of these markets. We’re also starting to develop our business in India; it’s a huge market with huge potential,” says Mogi. “And South America—that’s another big market, one that we’re also in the process of developing. Believe me, there is plenty of room for growth, regardless of economic ups and downs. If our managers are smart, well-informed and not afraid of risk, our global business will keep growing.”

With his energy, vision and experience, it seems very possible that even a decade from now, Yuzaburo Mogi may still be guiding his company to greater heights.

www.kikkoman.com/en/