Καλύτερες Μετοχές για Έγκαιρη Ανίχνευση Καρκίνου και Υγρή Βιοψία (Αύγουστος 2026)

Ο Τελευταίος Μεγάλος Δολοφόνος – Καρκίνος

Over the last decades, modern medicine has accomplished miracles. Infectious diseases previously killed more people than any other cause, including old age.  The COVID pandemic taught us that this fight is still not over, but we are getting there with new technologies.  Still, another killer is very much active: Cancer.

Ο προσαρμοσμένος κατά ηλικία ρυθμός θνησιμότητας από καρκίνο έχει μειωθεί μόνο ~19% από το 1990. Τώρα είναι η κύρια αιτία θανάτου για άτομα κάτω των 85 ετών.

Πηγή: Ark Invest

Και επειδή μπορεί να εμφανιστεί σε οποιαδήποτε ηλικία χωρίς προφανή λόγο, είναι πολύ πιο τρομακτικό και διαταρακτικό από ασθένειες όπως η άνοια ή η νόσος του Αλτσχάιμερ. Και ενώ έχουν σημειωθεί κάποιες προόδους, παραμένει εξαιρετικά θανατηφόρο.

And treatments are, for the most part, rather crude, involving massive amounts of toxic chemicals or irradiating body parts.

Η Μοναδικότητα του Καρκίνου

Calling cancer a disease obfuscates what it really is. Most diseases are either infectious or caused by a single internal dysfunction. But cancer is more like a thousand different diseases stamped with the same label.

Κάθε καρκίνος ξεκινά με ένα κύτταρο του σώματος που πάσχει. Τα «σφάλματα» του γενετικού του προγράμματος αρχίζουν να μεταλλάσσονται και να αλλάζουν γρήγορα. Σε κάποιο σημείο, όλες οι κανονικές λειτουργίες σταματούν και πολλαπλασιάζεται ανεξέλεγκτα. Αν δεν σταματήσει, θα καταλάβει ολόκληρους όργανα και θα προκαλέσει θάνατο.

Αυτό σημαίνει ότι κάθε καρκίνος είναι μοναδικός. Κάθε ένας μπορεί να προέρχεται από διαφορετικό «σφάλμα». Τέτοια σφάλματα είναι συνήθως πολύ διακριτά μέχρι να φτάσουν στη φάση εκρηκτικής επέκτασης. Και τότε, μπορεί να είναι πολύ αργά.

So, when we talk of detecting cancer in modern medicine, we are really talking about detecting the thousands of mutations that can make a healthy cell turn cancerous.

Η Σημασία της Έγκαιρης Ανίχνευσης

Finding cancer early is absolutely vital. For a long time, the only way to find cancer was through direct observation: scanners, MRI, and direct biopsy (cutting off a little part of the organ suspected to harbor cancerous cells).

These methods are either not precise and sensitive enough (scanner, MRI) or too invasive (biopsy) to be done routinely. It mostly worked only for specific risks, like breast cancer and echographic detection.

The detection problem is especially pressing, as oncology visits have declined following COVID-19 and lockdown.

Πηγή: Ark Invest

A new step was the detection of cancer “markers.” It can be an abnormal level of some hormones or other bioproducts. This contributes massively to the little improvement in early detection we have seen over the last few years. Still, it mostly detects cancer only when it has already reached a critical size, enough to move the needle on these bioproducts concentration that it becomes obvious there is a problem.

Έτσι, το επόμενο βήμα πρέπει να είναι η άμεση ανίχνευση των καρκινικών κυττάρων σε πρώιμο στάδιο και σε πολύ χαμηλά επίπεδα συγκέντρωσης.

Μοριακή Ανίχνευση Καρκίνου

In biology jargon, the term molecular is generally equivalent to DNA/RNA. This method specifically detects cancer abnormal genetic sequences, or ctDNA (circulating tumor DNA).

The technology is promising but has been hampered by a few limitations so far:

• Πολύ χαμηλό όριο ανίχνευσης, καθιστώντας δύσκολη την ανίχνευση όγκων μικρότερων από 1-2 εκ. διαμέτρου.
• Καλύτερη ανίχνευση είναι μόνο για άμεση δειγματοληψία (βιοψία) αντί για μη επεμβατικές δοκιμές.
• Δοκιμή μόνο για έναν πιθανό καρκίνο τη φορά.
• Ορισμένοι καρκίνοι παράγουν λίγο ctDNA, καθιστώντας δύσκολη την ανίχνευσή τους.

Improvements in technology are bringing hope to change early diagnostic methods radically.

Πρώιμη Ανίχνευση Πολλαπλών Καρκίνων (MCED)

Detecting multiple cancers at once, from a simple blood sample, is the Holy Grail of oncology (this is why the leader in the field is a company called Grail; more on that below).

Such a method is also called “liquid biopsy.” Μπορείτε να διαβάσετε περισσότερα για το MCED στην ιστοσελίδα της Αμερικανικής Εταιρείας Καρκίνου and the MCED Consortium.

It already exists but was too expensive to be routinely done on the whole population. With their price falling by an x20-x25 factor in the last 7 years and still going lower, this is untrue. New tests also check for thousands of ctDNA simultaneously, increasing the sensitivity by x10 or more.

Πηγή: Ark Invest

The same method can also be used to assess remission.

Measuring ctDNA allows for reducing the number of patients suffering chemotherapies while getting even slightly less relapse.

Πηγή: Ark Invest

Lastly, some mutations will make the cancer cells more fragile to specific molecules or therapies. So, new detection methods allow for better therapy selection and increased survival rates.

All of this will make for an explosion in the market for molecular diagnosis of cancer. Currently a $5B market (2022), it could grow to $24B by 2030 and still have room to grow, with a total addressable market (TAM) of $95B.

Πηγή: Ark Invest

Κορυφαίες Μετοχές Υγρής Βιοψίας Μετοχές

1. Grail / Illumina

ILMN Διάγραμμα τιμής

Thanks to its Galleri cancer detection kit, Grail is the leader of the liquid biopsy technology, with a massive 140,000-participant clinical trial underway in the UK and is already available in the US.

Η Grail είναι αυτή τη στιγμή μέρος της Illumina, αλλά αυτό είναι περίπλοκο. Η Grail αποσπάστηκε από την Illumina το 2016. Στη συνέχεια συγκέντρωσε περισσότερα κεφάλαια, βελτίωσε την τεχνολογία της, και επανααποκτήθηκε από την Illumina το 2021 για 7,1 δισεκατομμύρια δολάρια, πολύ περισσότερο από ό,τι αποσπάστηκε.

And the story does not stop there. You see, Illumina is the leading manufacturer of genetic sequencers, so it is actually providing the required machinery to ALL of Grail’s potential competitors.

So, competition regulators were not happy with Illumina’s 2021 purchase of Grail. They wanted to stop it in the US and the EU, and Illumina ignored the criticism.

Most recently, on 3 Απριλίου 2023, the FTC (Federal Trade Commission) ordered Illumina to divest Grail.

“Τέλος, η Άποψη απορρίπτει τον ισχυρισμό των μερών ότι αυτή η εξαγορά είναι πιθανό να αποφέρει αποτελέσματα που σώζουν ζωές, σημειώνοντας ότι οι προβλέψεις αποδοτικότητάς τους ήταν ασαφείς, εγωιστικές και χωρίς υποστήριξη. Τελικά, η Άποψη υποστηρίζει ότι η ενθάρρυνση του ανταγωνισμού μέσω καινοτομίας μεταξύ των παρόχων δοκιμών MCED θα έκανε περισσότερα για τη διάσωση ζωών από ό,τι η άδεια σε έναν μονοπωλιστή να ενσωματωθεί κατακόρυφα και να καταλάβει την αγορά.”

Αυτή η Άποψη και η Διάταξη θα γίνουν πλέον οριστικές, εκτός εάν οι Απαντώντες υποβάλουν αίτηση επανεξέτασης σε ομοσπονδιακό Εφετείο Δικαστήριο εντός 60 ημερών από την ημερομηνία εξυπηρέτησης αυτής της Διατάξεως.”

Illumina’s embattled management has even dealt with the notorious Carl Icahn, the legendary activist investor, who criticized Grail’s acquisition.

So, while technically the most advanced, Grail is not the most straightforward option for investors.

Illumina shareholders might receive shares of Grail, but the details of such a deal, with lawsuits and counter-lawsuits with the FTC, could get messy before it is clear what the future corporate structure of Grail will be.

Illumina getting fined some serious money for its contempt of regulators’ opinion is also a distinct possibility.

2. Exact Sciences Corporation

Exact Sciences is using both DNA & RNA data to detect early cancer, which “simple” DNA tests might miss.

The company develops solutions for all the stages of cancer detection

Πηγή: Exact Sciences

It is also working on a new MCED test, which checks for 4 different biomarker classes simultaneously (DNA, RNA, proteins, methylation).

The company’s R&D efforts paid off, with revenue rising x5 since 2018. It is also worth noticing that the company showed a positive EBITDA for the first time in Q4 2022.

Πηγή: Exact Sciences

Exact Sciences seems like a good option for investors looking at profitable companies in early-stage cancer detection, with an equally good shot at developing an MCED test to compete with Grail. And without all the FTC orders and corporate complexity of Illumina.

3. Natera, Inc.

NTRA Διάγραμμα τιμής

Natera relies on cell-free DNA testing (cfDNA) for women’s health (embryo testing, hereditary cancers), oncology (tumor panel, early detection, residual disease test), and organ testing (kidney, heart, lung).

Πηγή: Natera

The company also sees significant potential for this technology for transplant testing, with only a 10-15% market penetration.

Natera has experienced aggressive growth, with the number of tests growing by 20%-53% every year since 2017, from half a million to 2.1 million tests in 2022.

It is also worth noticing that Natera has been really active in oncology only since 2020. Since 30% of oncologists have ordered their ctDNA residual disease test, Signatera has been an impressive clinical and commercial success.

Natera seems well positioned for Medicare and other public health programs to start pushing for more molecular testing and reimburse them better.

The company plans for 2023 revenue to be 25% higher than 2022’s, with stable R&D and operating expenses. This should still not be enough to reach profitability but would reduce the cash burn by $150M, to the $300M-$325M levels.

Investors in the company will need to pay a close eye on the company’s ability to reach profitability in 2024-2025. The potential threat of more innovative cancer screening tests, like MCED, should also not be ignored.

4. Guardant Health, Inc.

GH Διάγραμμα τιμής

Guardant has developed a liquid biopsy test relying on ctDNA and methylation detection, Guardant Shield.

It also works on complete genomic testing for advanced cancer, allowing for custom therapies/precision medicine. Guardant 360 Cdx is the first FDA-approved blood test for complete genomic testing.

Lastly, Guardant Reveal uses ctDNA to detect early possible cancer recurrence, the “first liquid-only test to detect minimal residual disease (MRD) in colo-rectal cancer, now available for breast and lung cancers.”

Πηγή: Guardant

The next step for Guardant is unifying all its tests under the Smart Liquid Biopsy platform. Most importantly, it will significantly boost the performance of the Guardant Reveal testing, with the company calling it “a larger blockbuster franchise in its early innings.”

Πηγή: Guardant

It is also working on a multi-cancer test, with hopes to submit it for FDA approval in 2026.

Investors should closely follow the growth of the existing product sales and the multi-cancer test clinical trials. Another close eye should be kept on free cash flow, with still negative FCF forecasted in 2025.

Πηγή: Guardant

Άλλες Εταιρείες

Other companies, which are not publicly listed, are equally active in making cancer detection as cheap, non-invasive, and powerful as possible.

Notably, Owlstone Medical developed “Breath Biopsy,” which can detect cancer or other diseases from a breath sample.

And Adela, studying the DNA-methylome for early cancer detection.

All in all, this extremely active sector of liquid biopsy is likely to make cancer a lot more survivable and detecting it a part of our routine health checks.