Liquid biopsy startup Thrive Earlier Detection Corp. has raised $257 million in a series B round led by Casdin Capital and Section 32. The funds will be used to finalize the design of its first product, Cancerseek, conduct a trial to support U.S. FDA approval and prepare for commercialization.

The round also included participation by new investors Bain Capital Life Sciences, Brown Advisory, Driehaus Capital Management, Intermountain Ventures, Janus Henderson Investors, Lux Capital, Moore Strategic Ventures, Perceptive Advisors, Rock Springs Capital, Sands Capital, funds and accounts advised by T. Rowe Price Associates and other undisclosed investors.

Combined with $110 million in series A funding in March 2019 led by Third Rock Ventures, the company has raised a total of $367 million. All of the series A investors were back for this latest round.

In conjunction with the financing, Thrive named Eli Casdin, chief investment officer at Casdin Capital, to its board.

David Daly, CEO of Thrive Earlier Detection Corp.

“We are absolutely thrilled with this development, and, obviously, it’s going to help us advance our mission. And that mission is changing the pace of cancer diagnosis to earlier when patients really have the greatest opportunity for a cure,” David Daly, Thrive’s CEO, told BioWorld.

Thrive’s vision is to incorporate Cancerseek, a blood test to detect multiple types of cancer, into routine medical care and change the paradigm from one in which most people receive cancer diagnoses after symptoms appear – often when the disease is advanced – to a reality where most cancers are diagnosed at earlier stages. The test would be used in combination with standard cancer screening tests, such as mammography, but also would aid in catching other cancers without screening options.

Technology licensed from Hopkins

Founded in May 2019 with offices in Cambridge, Mass., and Baltimore, Md., Thrive licensed its technology from Johns Hopkins University. The license included the Cancerseek technology, a DNA sequencing technology called Safe-SeqS (Safe Sequencing System), which enables the capture of rare circulating tumor DNA fragments that are known to be correlated with cancer, and a suite of supporting biomarker technologies. All three were developed in the laboratory of Bert Vogelstein, a professor of oncology in Hopkins’ Sidney Kimmel Comprehensive Cancer Center and Thrive’s scientific co-founder.

While there are other companies pursuing liquid biopsy tests for cancer, Thrive believes its formula offers unique advantages over the competition – most of which either do tumor profiling for patients already diagnosed with cancer or screen for a single cancer type. Only Grail Inc., of Menlo Park, Calif., currently is developing a multicancer earlier detection test.

“From a technological approach, there [are] a couple of things that we do that are very different,” said Isaac Ro, CFO of Thrive. “One is that we’re using markers that are known biology, meaning markers that are irrefutably linked to cancer, validated through years and years of work. We’re also looking with a multianalytic approach, meaning both DNA and proteins together.”

Add to that a biomarker footprint that is very narrowly curated, and “we have what we think is going to be a winning formula,” he told BioWorld.

“To do all that with a test that we think will be extremely cost advantageous vs. any other approach … is also important,” Ro said, “because most people do not have cancer, and so when you screen a population, the insurance companies are going to be very sensitive to the price they pay to find those cancers.”

DETECT-A study

In its short life, the company has achieved several milestones. In April at the American Association for Cancer Research annual meeting, Thrive reported the first-ever results of a prospective, interventional study, DETECT-A, using a liquid biopsy in a real-world setting to detect cancer in a healthy population. The 10,000 all-woman study was conducted at Geisinger Health System in central Pennsylvania, and the results were simultaneously published in Science.

Current cancer screening tests detect about 25% of all cancers, meaning 75% go undetected until symptoms occur. In DETECT-A, a Cancerseek prototype picked up as many cancers as standard screenings. When confirmed by PET-CT, which is how Thrive envisions the test being used, the liquid biopsy had only a .5% chance of wrongly flagging cancer. The test accurately detected cancers, such as stage 1 ovarian cancer, that have no early detection options today.

Thrive has been working with the FDA to design a robust registrational trial for Cancerseek, leveraging what it did in the DETECT-A study. The technology garnered breakthrough device status in the fall of 2018.

“This is going to be significantly bigger” and will include both men and women, Daly said. The new study also will include multiple partners across the U.S. to be more representative of the general population, “with an intended use really focused on multicancer in an asymptomatic, average-risk population.”

At the same time, Thrive has engaged across the payer spectrum to ensure reimbursement coverage when Cancerseek is approved.

Other milestones

In addition to its clinical achievements, Thrive has grown its team from fewer than 30 to more than 100 people, and it has built up infrastructure with labs in Baltimore and Cambridge. “We’ve spent the last 12 months really building those out to support our development work, to prepare for the initiation of the FDA registrational trial and then, finally, to get ourselves in a position to launch commercially at scale,” Daly said.

Ro said there are several things the company is doing with its business model to make its approach both scalable and increasingly differentiated over time. Because the test combines next-generation sequencing with artificial intelligence, Thrive intends to have a learning aspect to its platform that updates and improves the algorithms with feedback from new data and imaging. “We’re just beginning to scratch the surface of what’s possible there,” he said.

The company also is looking at how to access primary care, in its various forms, and seamlessly integrate Cancerseek into that community. Broad adoption of the test could help to democratize early cancer diagnosis and generate additional real-world data to better understand cancer.

“We need to make it easy and straightforward, but we [also] need to invest now in understanding those right ways to introduce a novel approach like this to cancer screening, so we can gain this critical experience not only through the trial, but other ways of generating this real-world data to augment our clinical development efforts,” Daly said. “That will not only help us with the clinical community, but then that in turn helps us with the payer community as well.”

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