Grail, Inc. · NASDAQ:GRAL
Grail — Technical Presentation (August 2025)
12 slides from Grail's technical presentation, Aug 12, 2025
Slide 1: Prognostic significance of blood-based multi-cancer detection in ctDNA: 5-year outcomes analysis
Prognostic significance of blood-based multi-cancer detection in circulating tumor DNA (ctDNA): 5-year outcomes analysis Charles Swanton, MD, PhD1; Alan Bryce, MD2; Allen L Cohn, MD3; Matthew Margolis, MS4; Earl Hubbell, PhD4; April Sagan, PhD4; Oliver Venn, PhD4; Michael Seiden, MD, PhD5 1 Cancer E
Slide 2: Key Takeaways of 5-Year Follow-up Analysis of a Multi-Cancer Early Detection (MCED) Test
Key Takeaways of 5-Year Follow-up Analysis of a Multi-Cancer Early Detection (MCED) Test Survival differences between detected and undetected cases largely explained by clinical factors ● Undetected cancers follow a more indolent course, particularly at early stages MCED Testing of Comparison of Par
Slide 3: MCED Tests Detect a Cancer Signal and Predicts the Site of Origin
3 MCED Tests Detect a Cancer Signal and Predicts the Site of Origin An MCED test that uses targeted methylation sequencing of circulating tumor DNA (ctDNA) in blood was developed in the case-control Circulating Cell-free Genome Atlas (CCGA) Study1 (NCT02889978) ● The MCED test detects a shared cance
Slide 4: Analysis of ctDNA May Have Prognostic Implications Beyond Early Cancer Detection
4 Analysis of ctDNA May Have Prognostic Implications Beyond Early Cancer Detection High levels of ctDNA in the blood have been associated Later stage cancers Poorer prognosis Aggressive cancers Metastasis with:1-3 Tumors that do not shed detectable levels of ctDNA have Early-stage cancers Better pro
Slide 5: Reframing Our Understanding of Survival in Those With a Detected/Not Detected MCED Test Result
5 Reframing Our Understanding of Survival in Those With a Detected/Not Detected MCED Test Result Previous CCGA analysis (Chen, et al)1 New CCGA analysis ▪ Early version of the MCED test validated ▪ Refined version of the MCED test in the second CCGA substudy clinically validated in the third CCGA su
Slide 6: Standardization to SEER Reference Reduces Expected Variation From Known Survival Predictors
6 Standardization to SEER Reference Reduces Expected Variation From Known Survival Predictors Observed survival at 5 years was compared with expected survival calculated from SEER reference data using a one-sample proportional hazard model Observed survival for Participants with a Cancer Signal Dete
Slide 7: Survival Advantage for NCSD Versus CSD Cancers Remains After Controlling for Known Survival Predictors
7 Survival Advantage for NCSD Versus CSD Cancers Remains After Controlling for Known Survival Predictors Observed Survivala Vs Expected Survival by Signal Detection Status Hazard Ratios for Cancer Signal Detection Groups and SEER Reference Population NCSD Observed Survival: Hazard 88% 95% CI P-value
Slide 8: Observed Survival Curves Were Similar to or More Favorable Than Expectations—Even at Early Stages
8 Observed Survival Curves Were Similar to or More Favorable Than Expectations—Even at Early Stages Observed Survivala Vs Expected Survival by Stage and Signal Detection Status Stage CSD vs SEER NCSD vs SEER I 66% vs 71% 90% vs 85% II 64% vs 67% 92% vs 83% Overall Survival III 48% vs 42% 79% vs 66%
Slide 9: Early-Stage Cancers Detected by MCED had Survival Similar to Early-Stage Cancers in the SEER Population
9 Early-Stage Cancers Detected by MCED had Survival Similar to Early-Stage Cancers in the SEER Population Hazard Ratios for Cancer Signal Detection Group Vs SEER Reference Population by Stage ▪ Hazard ratios were calculated Hazard Ratio comparing matched SEER reference populations to signal detectio
Slide 10: Extended Follow-Up of CCGA Participant Outcomes Improves Understanding of Survival and MCED Detection
10 Extended Follow-Up of CCGA Participant Outcomes Improves Understanding of Survival and MCED Detection Strengths Limitations ▪ Broad sampling of cancer types and stages ▪ Non-interventional – Observational data across multiple care systems diagnosed through usual care ▪ SEER reference data used as
Slide 11: In Summary, 5-Year Follow-Up Analysis Suggests That Cancer Signal Detection May Inform Prognosis
11 In Summary, 5-Year Follow-Up Analysis Suggests That Cancer Signal Detection May Inform Prognosis Survival differences between detected CCGA Substudy 3 Outcomes and undetected cases largely Analysis explained by clinical factors ●There was evidence of a healthy volunteer bias when compared to age,
Slide 12: We acknowledge the contributions to this effort by the patients, staff, and healthcare providers
We acknowledge the contributions to this effort by the patients, staff, and healthcare providers who provided clinical data as part of the Circulating Cancer Genome Atlas Study. Copies of this slide deck obtained through Quick Response (QR) Questions? Code are for personal use only and may not be re