Grail pioneered multi-cancer tests. But the company’s rough public debut shows the industry could be in trouble

Is Grail’s lurching start as a newly public company a bad omen for what some view as the future of cancer testing?

In its first week of trading since being spun off from Illumina, investors have valued California-based Grail at less than $500 million. That’s about 1/16th of the $8 billion that Illumina paid to buy it in 2021, on the hope that Grail’s blood test could screen for many cancers at once and become a backbone of oncology surveillance.

When Grail launched in 2016, backers like Bill Gates and Jeff Bezos were drawn to the idea of a broad test to help catch malignancies early while saving lives and money. Legendary biotech investor Bob Nelsen of ARCH Venture Partners made it his firm’s largest-ever investment at the time.

But in the years since, the field has been held back by questions over accuracy and the…
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