How about the $100M Holy ‘GRAIL’ in Cancer Diagnostics? A Universal Test Start-up Faces German Competition

Universal cancer diagnostic test illumina bill gates grail guardant health ngs

Illumina, the €22Bn Market cap NGS specialist, and Bill Gates pooled a $100M to fund the startup, ‘Grail’, which will be used to find a universal cancer detection test for Doctors.

illumina_ngs_bill_gates_cancer_diagnostics_liquid_biopsiesThe startup will be based in San Francisco (US) with additional financial backing to include Bill Gates amongst others.  The tests in question are based on the super-sensitive sequencing technology that Illumina had developed for blood tests, able to detect micro-traces of DNA.

And this was around 18 months ago… now the NGS Super Company is projecting costs of such diagnostic tests to be only around $1,000.

The idea for such ‘Liquid Biopsies’ however is not exclusive to Illumina’s network, as another Biotech, Guardant Health, was the first liquid biopsy to be offered to doctors in the United States. The technique was originally discovered and refined at John Hopkins University, the full story of which you can read in MIT’s Technology Review.

Guardant Health’s technology can now non-invasively see the genomic dimension of cancer throughout a patient. Their Digital Sequencing enables ultra high-fidelity, single-molecule detection of actionable tumor-specific genomic alterations in cancer (Source: Guardant Health)

Although $1,000 may seem like a tall price for a diagnostic test, given the number of types of cancer reaching around 200 (according to Cancer Research UK), one test for all types is actually a very attractive choice compared to testing individual cancers at Guardant’s pricing (€4,960 per test).

So who is is working in the Liquid Biopsy Field?

German New Oncology completed a financing round to prepare the market launch of NEOliquid, a non-invasive blood test that identifies therapeutically actionable genome alterations in the circulating free tumor DNA (ctDNA) of cancer patients.

New Oncology has also been investigating novel gene biomarkers in rarer cancers, such as infant Neuroblastoma, which they published in Nature in October (in collaboration with the University of Cologne).

How New Oncology’s Liquid Biopsy diagnostic test for Cancer works using circulating DNA (Source: New Oncology)

Eight other tests have also since reached the market, including one for lung cancer (such as the Boston Personal Genome Diagnostics). Another example in the EU is the German-American Epigenomics, which is carrying out its trial for Epi proColon, its non-invasive blood-based test for colorectal cancer (CRC) screening.

Then there is AstraZeneca and Qiagen’s therascreen EGRF test as a companion diagnostic test being used with Iressa, a first-line treatment for a common form of lung cancer which received FDA back in July.

Finally, another key player in the Liquid biopsy field is Sysmex Inostics’ highly sensitive OncoBEAM services which already detect a wide variety of clinically actionable genetic mutations in various cancers like melanoma, colorectal, breast and lung cancer.

So clearly the basis for a universal test already exists, even if the full screen hasn’t yet been assembled, and I can’t help but wonder what precisely Illumina’s new baby ‘Grail’ has that other competitors do not…

Feature Image Credit: Guardant Health

UPDATE: Error in figures Guardant Health’s Fundraising (actual figure approx $200M)

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