In his final State of the Union, President Obama announced the Cancer Moonshot, an ambitious national effort to accelerate cancer research. Critics said it was mission impossible.
At Guardant Health, we believe that no single entity can deliver on the goals of the Cancer Moonshot, and it will take a coordinated effort to bend cancer mortality curves. Our contribution, data associated with Guardant360, the industry’s gold-standard non-invasive genomic cancer test, is a key enabling tool that will reach its full potential only when combined with improved methods for sharing and analyzing clinical data, drug discovery and validation engines, advances in basic science, and coordinated governmental processes for drug approvals.
Today’s launch of the Blood Profiling Atlas, an open database of blood-based cancer genomic profiles and analytical methods, is proof that the Moonshot can make rapid progress. A diverse group of diagnostic, pharmaceutical, and digital health companies representing the entire cancer “stack,” along with academic researchers are contributing their data and expertise. Guardant Health is proud and excited to be a part of the effort, and as the pioneers in liquid biopsy, we believe we can help conquer cancer with data. The value of liquid biopsies lies not only in their role as a critical tool for cancer management, but in the data they reveal and the ease and frequency with which these data can be obtained.
Having sequenced nearly 30,000 patients with our clinical test, Guardant360, we know that liquid biopsies are already a critical and often life-changing non-invasive alternative to match advanced cancer patients with targeted therapies.
As a result, Guardant360 is quickly being incorporated into the standard of care in many major cancer centers across the United States. Indeed, over 30% of lung cancer patients are not genotyped in accordance with basic recommendations from national guidelines committees, and almost 85% are not genotyped with respect to their more advanced suggestions. A fundamental reason for this extraordinary gap is the difficulty of accessing lung tumor biopsy tissue given the procedure’s $14,000 cost, 19% complication rate, and >1% mortality rate.
Thus, accessing tumor DNA in cancer patients using direct tissue biopsies often comes with great risk and expense, creating an “inertial barrier” for obtaining genomic data. At Guardant Health, we have worked to reduce this barrier via Guardant360, as we believe this will lead to dramatic non-linear improvements in our collective understanding, and therefore approaches, to treating cancer. For example, our profiling of thousands of patients who have undergone one or more lines of therapy is already shedding light on how cancer responds to treatment. We are reminded by numerous specific patient examples in which tissue profiling missed information necessary to select the next therapy, often due to the heterogeneous nature of the disease. In these cases, blood-based profiling was able to pick up acquired resistance mutations that were the key for unlocking the next appropriate therapy. The Blood Profiling Atlas is an important affirmation of our approach to decoding cancer evolution, and a reminder that we are just scratching the surface.
Furthermore, reducing inertial barriers not only increases efficiency and our pace of learning, it creates new applications. The move from tissue to blood in oncology echoes the change from wired to wireless communications. Wireless turned out to be far more than just a substitute for when wired connections were unavailable. It was a catalyst for world-changing applications that required wireless connectivity like Uber, Waze, WhatsApp, FaceTime, and many more.
Similarly, the breakthrough of liquid biopsies is not simply the ability to profile cancer patients’ tumors, but the promise that they can capture the whole-body summary of an individual’s cellular activity. Indeed, they open up a new way of precisely measuring molecular changes across disease states and in response to treatments at a vastly accelerated pace.
And like the breakthrough of wireless and subsequent deluge of inventions, we think this new platform will be the integral accelerant for enabling numerous essential health applications. These will likely include advances in early detection and disease monitoring, as well as many others yet to be imagined.
We are hopeful that the commitment we and other companies are making to the Blood Profiling Atlas will accelerate the adoption of this technology, spur advances in oncology, and unlock new applications to benefit clinicians and patients.