Grail, Inc. · NASDAQ:GRAL
Grail — Technical Presentation (April 2024)
15 slides from Grail's technical presentation, April 2024
Slide 1: Prognostic Significance of Blood-Based Multi-Cancer Detection in Cell-Free DNA: 4-Year Outcomes Analysis
Prognostic Significance of Blood-Based Multi-Cancer Detection in Cell-Free DNA: 4-Year Outcomes Analysis Charles Swanton, MD, PhD1; Matthew Margolis, MS2; Earl Hubbell, PhD2; Kathryn N. Kurtzman, MD2; Stephannie Shih, PhD2; Oliver Venn, PhD2; Michael Seiden, MD, PhD3 Affiliations: 1Cancer Evolution
Slide 2: Disclosure Information
Disclosure Information Charles Swanton I have the following relevant financial relationships to disclose: ▪ Employee of: Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute; Cancer Research UK; University College London ▪ Consultant for: Achilles Therapeutics; Bicycle The
Slide 3: Detection of Cancer Signals May Lead to Earlier Diagnosis and Improved Survival
Detection of Cancer Signals May Lead to Earlier Diagnosis and Improved Survival The Multi Cancer Early Detection (MCED) test detects a shared cancer signal associated with >50 cancer types, most of which have no guideline-recommend screening. Third (Validation) Substudy of the CSO Prediction Case-Co
Slide 4: How Do We Refine Our Understanding of Survival in Those With a Detected/Not Detected MCED Test Result?
How Do We Refine Our Understanding of Survival in Those With a Detected/Not Detected MCED Test Result? Previous analysis (Chen, et al)1 New analysis ▪ Assessed participant outcomes in the second (cross-validated) CCGA substudy ▪ Assessed participant outcomes in the third CCGA (validation) substudy2
Slide 5: Almost 70% of Participants Diagnosed With Cancer Were Alive After 4 Years
Almost 70% of Participants Diagnosed With Cancer Were Alive After 4 Years CCGA Substudy 31 Confirmed Status Participants who received the MCED test Analysis Set had their cancer status confirmed 1-year N=4077 post-enrollment Participants without cancer: Participants with stageable n=1254 invasive ca
Slide 6: A Higher Proportion of Those Diagnosed with Cancer Who Died During Follow-up Had Cancer Signal Detected
A Higher Proportion of Those Diagnosed with Cancer Who Died During Follow-up Had Cancer Signal Detected CCGA Substudy 31 Confirmed Status Analysis Set N=4077 Do participants with a cancer signal detected fare worse? Participants without cancer: Participants with stageable To answer this question, we
Slide 7: Standardization to SEER Reference Removes Expected Variation from Known Predictors
Standardization to SEER Reference Removes Expected Variation from Known Predictors What Factors Contribute to Cancer Observed survivala of participants who had 4-year Survival Among Detected/Not longitudinal follow-up data was compared to expected Detected Groups? survivalb calculated from SEER refe
Slide 8: Survival Advantage for Cancer Signal Not Detected Remains After Removing Known Effects
Survival Advantage for Cancer Signal Not Detected Remains After Removing Known Effects Hazard Ratio for Cancer Signal Detection Groups After Observed Survivala vs Expected Survival by Signal Detection Status Controlling for Age, Sex, Cancer Type and Stage Hazard 95% CI P-value Ratio Not Detected Not
Slide 9: Hazard Ratios Most Important To Understand Prognosis at Early Stage When Treatment is Most Effective
Most Important To Understand Prognosis at Early Stage When Treatment is Most Effective Observed Survivala vs Expected Survival by Stage and Signal Detection Status Hazard Ratios by Stage for Cancer Signal Detection Controlling for Age, Sex, Cancer Type and Stage Hazard Ratios ▪ Stage I/II in Detecte
Slide 10: Potential For Future Refinement of Prognoses Using Estimates of Cancer Biology
Potential For Future Refinement of Prognoses Using Estimates of Cancer Biology Tumor Methylated Fraction1: Tumor Methylated Fraction by Cancer Signal Detection Status and Stage at Diagnosis A methylation-based, biopsy-free estimate of circulating tumor DNA within cell-free DNA ▪ Estimator designed t
Slide 11: 4-Year Follow-Up Analysis Suggests That the MCED Test Preferentially Detects Fast-Growing Cancers
4-Year Follow-Up Analysis Suggests That the MCED Test Preferentially Detects Fast-Growing Cancers CCGA Substudy 3 Outcomes Analysis Survival Across Cancer Cases ● Most variation was due to clinical factors ○ Evidence of a healthy volunteer bias when compared to age, sex, and tumor matched controls M
Slide 12: Ongoing Follow-up of CCGA Participant Outcomes Improves Understanding of Survival and MCED Detection
Ongoing Follow-up of CCGA Participant Outcomes Improves Understanding of Survival and MCED Detection Strengths Limitations ▪ Broad sampling of cancer types and ▪ Non-interventional – Observational data stages, across multiple care systems diagnosed through usual care ▪ SEER reference data used as a
Slide 13: Questions?
We acknowledge the contributions to this effort of the patients, staff, and healthcare providers who provided clinical data Questions?
Slide 14: Appendix Slides
AAGR American Association for Cancer Research’ 2024 * SAN DIEGO Appendix Slides
Slide 15: Cancer Signal Detection Varied by Cancer Type and Stage, Which Independently Affect Survival
Cancer Signal Detection Varied by Cancer Type and Stage, Which Independently Affect Survival Stage distribution for the 21 most common AJCC stageable cancer types in CCGA Substudy 3 by cancer signal detection status 200 0 200 50 25 0 25 50 No Cancer Signal Cancer Signal No Cancer Signal Cancer Signa