Grail, Inc. · NASDAQ:GRAL

Grail — British Thoracic Oncology Group 2024

12 slides from Grail's conference presentation, April 2024

  1. Slide 1: Utility of PET-CT for nodule discrimination in the SUMMIT Study

    UCL Respiratory Utility of PET-CT for nodule discrimination in the SUMMIT Study British Thoracic Oncology Group April 2024 Dr Priyam Verghese Clinical Research Fellow UCL Respiratory

  2. Slide 2: The SUMMIT Study

    UCL Respiratory The SUMMIT Study • The SUMMIT Study aims to assess implementation of LDCT screening for lung cancer in a high-risk population, and validate a multi-cancer early detection blood test • Prospective cohort study • Operational from 2019 – 2023 • Total number of participants recruited: 13

  3. Slide 3: Utility of PET-CT

    UCL Respiratory Utility of PET-CT • PET-CT usually performed to evaluate clinically detected pulmonary nodules ≥8mm that have remained stable after interval CT imaging • Additionally, it is a non-invasive method of mediastinal staging and and exclusion of metastases in suspected early-stage lung can

  4. Slide 4: Cohort summary

    UCL Respiratory Cohort summary Participants referred to Lung Cancer MDT who have subsequently undergone at least one PET-CT which shows a persisting nodule Total n = 662

  5. Slide 5: Results summary

    UCL Respiratory Results summary

  6. Slide 6: Results of PET-CT evaluation according to nodule characteristics and screening round

    UCL Respiratory Results of PET-CT evaluation according to nodule characteristics and screening round Positivity threshold: nodule SUVmax ≥2.5 or nodule characterised as moderate or intense on BTS ordinal scale Reference standard: histology or stability on surveillance imaging >24 months

  7. Slide 7: Results of PET-CT evaluation according to nodule characteristics and screening round

    UCL Respiratory Results of PET-CT evaluation according to nodule characteristics and screening round Positivity threshold: nodule SUVmax ≥2.5 or nodule characterised as moderate or intense on BTS ordinal scale Reference standard: histology or stability on surveillance imaging >24 months

  8. Slide 8: ROC Curves by Nodule Size in SUMMIT

    UCL Respiratory ifh ROC Curves by Nodule Size in SUMMIT 1.0 J eo | = 3 a r= Z 7) c a) n+ j Oo AUC: 0.760 ~ | AUC: 0.710 — Whole cohort S AUC: 0.766 — <10mm AUC: 0.814 —— >10mm <20mm AUC: 0.893 —— >20mm <30mm : | —— >30mm <50mm I | 0.0 0.2 0.4 0.6 0.8 1.0 1 - Specificity

  9. Slide 9: ROC Curves by Nodule Type in SUMMIT

    UCL Respiratory ifh ROC Curves by Nodule Type in SUMMIT So | 2 _| oO © | po = 7) Cc () nO _| oO x | J AUC: 0.760 AUC: 0.803 — Whole cohort AUC: 0.685 Sod cS Ll —— Part solid oO T T T T T T 0.0 0.2 0.4 0.6 0.8 1.0 1 - Specificity

  10. Slide 10: ROC Curves by Screening Round in SUMMIT

    UCL Respiratory ifh ROC Curves by Screening Round in SUMMIT So Ll oO _| oO © _} po $ = Cc oO oO ~s _| oO N _} 3 AUC: 0.812 AUC: 0.631 — B | AUC: 0.706 eet So —— Year 2 oO T T T T T T 0.0 0.2 0.4 0.6 0.8 1.0 1 - Specificity

  11. Slide 11: Conclusions

    UCL Respiratory Conclusions • Current evidence base for use of PET-CT in screen detected nodules is limited • We demonstrate that PET-CT has sub-optimal sensitivity, specificity and NPV in discriminating malignant from benign nodules in a screening cohort. • Performance is inferior for sub-centimetr

  12. Slide 12: Thank you! Any questions?

    UCL Respiratory • Thank you! • Any questions?

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