Genecast Leverages Multi-Dimensional Liquid Biopsy Platform for Comprehensive Tumor Assessment Amid Hong Kong IPO Filing

Image provided by Genecast

Since the beginning of this year, the entire team at Genecast has been consistently busy. The 2018 “CSCO-Genecast Forum on Precision Oncology,” co-organized by Genecast and the Chinese Society of Clinical Oncology (CSCO), has been held across China. Following its launch in Shenzhen in May, the Chengdu session marked the second installment of the series.

In the past two years, competition in NGS-based clinical oncology testing services has become intensely fierce. All stakeholders are eager to accelerate the clinical adoption of this technology, aiming to provide patients with real-time and precise information on medication guidance, efficacy monitoring, prognostic assessment, and mechanisms of drug resistance, thereby facilitating precision medicine.

Before founding the company, Du Bo worked in drug R&D and management, as well as in investment. Overall, from graduation through his professional career, he has remained within the life sciences sector, accumulating extensive experience and industry connections that laid the foundation for his subsequent entrepreneurial ventures.

In 2010, Illumina reduced the cost of sequencing to $1,000, sending shockwaves through the entire industry. It was around that time that Du Bo entered the field of next-generation sequencing (NGS), recognizing that technological advancements would inevitably deliver substantial value. New methodologies have the potential to revolutionize our understanding of disease.

“It has the potential to transform tumor diagnosis,” Du Bo told VCBeat in an interview. The clinical application of NGS will enable a deeper, molecular-level understanding of cancer, and new approaches may fundamentally reshape our perception of disease.

“At the time, I felt it was a very important market,” recalled Du Bo.

His core team includes medical experts with over a decade of experience in translating clinical research into practical applications, as well as business management professionals who have spent many years marketing oncology drugs at top global pharmaceutical companies. “Technological advancements are occurring at a rapid pace; more importantly, it is crucial to swiftly translate these innovations into real-world diagnostic products and methods that benefit patients,” said Du Bo. In this field, Genecast has undertaken numerous novel explorations.

In March 2018, the National Cancer Center released the "2018 China Cancer Report" (as cancer statistics in China typically lag by three years, the latest data published were from 2014). The report showed that in 2014, there were 3.804 million new cases of malignant tumors nationwide (2.114 million in males and 1.690 million in females), with an average of more than 10,000 people diagnosed with cancer each day, equivalent to seven people diagnosed every minute.

Lung cancer has the highest incidence rate in China, with approximately 781,000 new cases annually, followed by gastric cancer, colorectal cancer, liver cancer, and breast cancer. Lung cancer and breast cancer rank first in incidence among men and women, respectively.

Clinically, a definitive cancer diagnosis typically requires a needle biopsy, an invasive procedure that imposes a significant physical burden on patients. Furthermore, since needle biopsies sample only a portion of the tumor, they are subject to tumor heterogeneity and thus cannot accurately represent the entire tumor tissue. Additionally, performing a needle biopsy is technically challenging when the tumor is small.

Liquid biopsy is convenient and non-invasive during sampling, overcomes the limitations imposed by tumor heterogeneity in tissue biopsy, and reflects the overall characteristics of the tumor.

Imaging modalities commonly used in oncology can typically determine only the location of a tumor, making it difficult to accurately distinguish between benign and malignant lesions. (Although some experienced physicians may make such determinations directly from contrast-enhanced imaging, this approach relies heavily on individual clinical expertise.)

The advent of targeted therapies and immunotherapies has ushered in a new era in oncology treatment. However, no single technology can address all challenges; neither targeted drugs nor immunotherapies are effective for every patient.

The same drug does not necessarily yield identical therapeutic outcomes for patients with the same type of cancer. Next-generation sequencing (NGS)-based molecular diagnostic technologies have elucidated the underlying reasons. Even within a single cancer type, there exist distinct subtypes corresponding to different mutation sites; conversely, if different cancers share the same mutation sites, patients may still respond to the same drug. These principles underpin the classic “umbrella trials” and “basket trials” in precision medicine.

Liquid biopsy using ctDNA and CTCs not only serves as a treatment monitoring tool but also enables early screening for tumors, which holds significant value for the subsequent management of cancer.

Moreover, due to its minimal invasiveness, ease of sampling, and ability to reflect the overall tumor status, liquid biopsy serves as a powerful tool during cancer treatment and in post-treatment monitoring.

Liquid biopsy has revolutionized modern medicine’s understanding of tumors and transformed treatment paradigms, offering greater hope to both physicians and patients.

JPMorgan predicts that the global liquid biopsy market will reach $23 billion in 2020, while Goldman Sachs forecasts that the U.S. share of the liquid biopsy market will amount to $14 billion in 2020. Guosen Securities projects that the number of cancer patients using liquid biopsy in China will reach 5 million in 2020. Based on a 50% penetration rate and a testing frequency of four times per year, if the price per test is RMB 2,000, China’s liquid biopsy market will reach RMB 20 billion in 2020.

On this basis, the value of liquid biopsy extends beyond tumor diagnosis itself to include commercial and social value.

Leveraging its established ctDNA extraction and quantitative detection technology platform, Genecast has built a technical platform in China focused on non-invasive testing for solid tumor companion diagnostics, prognostic assessment, and medication guidance, covering pan-cancer detection including lung cancer, colorectal cancer, liver cancer, esophageal cancer, endometrial cancer, ovarian cancer, and cervical cancer.

“In addition, Genecast is not just a non-invasive blood testing platform,” Du Bo told VCBeat. Besides blood tests, they have also established a technical platform for tissue testing.

Image provided by Genecast

Du Bo believes that achieving a comprehensive and holistic assessment of tumors requires a multidimensional evaluation approach, which demands significant investment of time and effort from enterprises.

In this process, Genecast has also undertaken various new initiatives, such as auxiliary diagnostics for immunotherapy, targeted therapy, and radiochemotherapy.

True disruptive innovation requires not only groundbreaking technology but also an environment that fosters its growth. Du Bo revealed that Genecast has also made significant efforts in standardizing quality control and medication guidance.

Currently, all blood samples on the NGS technology platform undergo EGFR validation. Through dual-platform cross-validation using both NGS and ddPCR platforms, accurate detection for medication guidance is ensured.

So, ultimately, how does this technology facilitate the clinical diagnosis and treatment of cancer?

“This industry is highly unique, serving as both an application and an exploration,” said Du Bo. On one hand, they need to collect and organize existing information and data; on the other, they must continuously explore new information and evidence.

He explained to VCBeat that tumors themselves evolve rapidly, and corresponding treatment regimens are also changing. According to news reports, in 2018, a patient with stage IV breast cancer and widespread metastasis was ultimately completely cured—a scenario previously unimaginable. “This successful case was not accidental; the trial has also been proven to be reproducible,” he stated. “Our goal is to leverage existing, well-established evidence to guide patient treatment. At the same time, we aim to utilize these test results to collaborate with physicians in exploring novel integrations between therapy and diagnosis.”

Liu Lunxu, Vice President of West China Hospital, told VCBeat, “Compared with tissue biopsy for solid tumors, liquid biopsy is much less invasive to sample; for patients, it is as simple as undergoing a routine blood test.”

For physicians, liquid biopsy serves as a powerful tool for monitoring treatment and predicting prognosis. Liu Lunxu told the reporter, “It can reflect surgical outcomes from multiple perspectives, such as whether the tumor has been completely resected, whether postoperative metastasis has occurred, and even predict patient survival.”

“The greatest significance of this process lies in its ability to guide physicians in medication selection. Based on these mutations, we can predict which drugs a patient is more likely to respond to. ‘Extensive research has demonstrated the value of this approach in oncology treatment. However, there are still many underlying patterns to be explored,’ he stated. ‘Overall, the future holds great promise.’”

As a surgeon, he has a more profound appreciation of the clinical value of liquid biopsy.

First, this is reflected in the precision of treatment. “Whether it involves pharmacological therapy or surgical intervention, the selection of treatment regimens has become more precise than before,” stated Liu Lunxu. In surgical practice, liquid biopsy provides quantifiable indicators for determining patient candidacy for surgery, defining the extent of resection, and achieving precise localization preoperatively and intraoperatively. Previously, such decisions relied primarily on imaging studies or physicians’ individual clinical experience.

Image provided by Genecast

“In surgical procedures, the primary issue addressed by liquid biopsy is enabling patients to achieve the fastest and most comprehensive recovery with minimal trauma, while also maximizing long-term survival,” he stated.

Another aspect is reflected in new treatment regimens, such as targeted therapy and immunotherapy. Liu Lunxu told VCBeat that advanced-stage tumors, which were previously untreatable, may show significant improvement with these medications, and some patients can even achieve long-term survival while living with the disease.

However, not all patients are suitable for these medications, and some may develop drug resistance after a period of treatment. If drug resistance occurs and subsequent testing identifies a new mutation for which targeted therapies are available, patients can continue to receive effective treatment and survive, despite disease recurrence.

“In this way, previously dangerous and fatal diseases can gradually become chronic conditions,” he added. “Treatment outcomes have improved significantly.”

“Of course, there are still some tumors that we have not yet conquered.” He continued. Every tumor patient's situation is different, and the mutations in each cell within different tumors may also vary. A single drug cannot cover all patients with the same type of cancer.

“Some patients may share common characteristics and thus be suitable for the same medication. However, current precision therapy still targets broad patient categories. In the truest sense, our goal is to achieve precision at the individual patient level, thereby realizing truly personalized precision medicine,” stated Liu Lunxu.

“Due to the high suppressive nature of tumors, phenotypic switching or new mutations are highly likely to occur during treatment. ‘Therefore, to truly and thoroughly address the challenge of cancer, I believe we must move toward customizing drugs and therapeutic regimens for each patient to manage the dynamic evolution of the disease,’ said Liu Lunxu.”

He revealed that West China Hospital has also conducted extensive basic and applied research in this area, including tumor immunology and the tumor microenvironment. “In terms of precision medicine, immunotherapy represents another major direction. But this is only the beginning,” he said.

It is understood that Genecast and West China Hospital had previously launched scientific research collaborations on clinical exploration of genetic testing, including NGS-based treatment prediction, medication guidance, and survival prediction.

Genecast itself is also conducting extensive cutting-edge explorations. In addition to its leading position in the precision treatment of non-small cell lung cancer, the company has also carried out research and exploration into immunotherapy for solid tumors, such as gastrointestinal cancers.

“Some patients have a very favorable prognosis after medication, while others progress even faster than if they had not taken the drug. We explored these phenomena,” said Du Bo. Such cases are highly prevalent among patients with gastrointestinal tumors, accounting for up to 20%. In other words, this subset of patients experienced accelerated mortality following drug administration.

“This situation requires extensive screening, and we have conducted substantial research, particularly in data accumulation,” said Du Bo.

It is reported that the manuscript for this research project has currently been submitted.