Early is Good

Building the Future of Early Detection.

[Chamath Palihapitiya @chamath]

Everything about cancer sucks.

Some of the most difficult decisions in cancer are what to do and when to do it: biopsy, resection, passive monitoring etc.

Today, clinicians make irreversible calls like 1) do a biopsy or wait, 2) treat or monitor or 3) remove an organ or monitor, using tests that cannot see the full biology of either the body or the cancer. As a result, doctors often overtreat the wrong patients while missing dangerous cancers in others until it’s too late.

Five years ago, a sibling trio of Purdue grads cold emailed me from Indianapolis. Their thesis was simple: the science in cancer detection and treatment isn't the bottleneck. The engineering is.

Fix the engineering, and you can change the standard of care of cancer forever.

We founded @EarlyIsGood together to do this.

Here is our mid-decade update after five years (!) of toil. We’ve made some good progress.

1. The Engineering Unlock: Multiomics

Most diagnostics fail because they are looking for a needle in a haystack. The results are modest and create many false positives and false negatives. We developed nanotechnology that amplifies the needle making it simpler for us to figure out what is going on.

Our nanotechnology allows us to read DNA, RNA, and Proteins simultaneously from a single sample.

We detect Proteins at attomolar sensitivity (1000x ELISA) and RNAs at PCR-level sensitivity all without extraction or amplification.

Combining all three provides a full picture because: 
- DNA tells you what mutations are present
- RNA tells you what the cancer is doing
- Proteins tell you how the body is responding

2. The Proof: Bladder Cancer 

We started here because the standard of care today is barbaric. 800,000 people are under surveillance for bladder cancer, enduring invasive cystoscopies that still miss ~20% of tumors.

We are finishing a multisite prospective trial now.

Standard of Care (Cystoscopy): invasive, repeated every 3-6 months.

Our bladder cancer test (BCDx): 92% sensitivity and 97% specificity from a simple urine sample.

Most importantly, we catch the high-grade tumors that the current gold standard misses completely.

3. The Next Mountain to Climb: Prostate Cancer

If you’ve watched a father, brother, or friend get a high PSA result, you know the spiral that follows: months of terror, invasive procedures, and paralyzing uncertainty. 20M+ PSA tests are run annually. Most positives are false alarms, leading to 1M+ unnecessary, painful biopsies. Meanwhile, dangerous cancers are often missed.

Current commercial tests hover below 50% specificity. That means for every two men they flag, one is a false alarm.

We partnered with the Mayo Clinic to solve this.

No blood draws. No rectal exams. Just a simple urine test.

We are using the same platform that we validated on bladder cancer to achieve unprecedented specificity without sacrificing sensitivity, effectively separating those who need treatment from those who don't. 

We will soon be commercializing both our bladder and prostate cancer tests widely. Follow us @EarlyIsGood if you’d like to help or know when/where these tests are available.

[Early is Good @EarlyisGood]

@Degreez400 @chamath Appreciate the interest. The test isn’t available just yet. Sign up at https://t.co/TEPS5nV7b8 and we’ll let you know as soon as it is.

[Early is Good @EarlyisGood]

@Pop_Collapse @chamath Right there with you. Sign up at https://t.co/TEPS5nV7b8 and we’ll keep you posted.

[Early is Good @EarlyisGood]

@AvgJoe308 @chamath Totally hear you, Joe. We designed the test for exactly that moment when PSA is elevated and it’s unclear what to do next. The goal is to catch the cancers that actually need treatment and avoid unnecessary procedures.

[Early is Good @EarlyisGood]

@trivlotus @chamath Great question. Our founder actually went through a similar false positive with ovarian cancer and it’s a big part of why we started this. We’re not on ovarian yet but the tech can absolutely go there. Please sign up for updates as we expand.

[Early is Good @EarlyisGood]

@Valenti99842103 @chamath Totally agree. Most urine tests out there still require a rectal exam. That’s why we’re building one that doesn’t. Just pee in a cup, no hassle.

[Early is Good @EarlyisGood]

@MartyEarthy @chamath Just added it Marty! Go ahead and sign up, we'll keep you in the loop!

[Early is Good @EarlyisGood]

@JohnJWinchester @chamath Thanks for the interest, John. We're getting close and will share timing updates soon.

[Chamath Palihapitiya @chamath]

Prostate cancer screening is broken in America so I started a company four years ago to fix it. We’re almost there with a highly accurate test for prostate cancer that is urine based.

Pee in a cup, know with precision.

Details below!

i. Over 20 million PSA tests are run each year in the U.S.

ii. More than 70% of positive results are false alarms, leading to over 1 million men undergoing unnecessary biopsies annually.

iii. Even when cancer is found, only 1 in 3 men actually need treatment but many still undergo surgery, radiation, or hormone therapy. These treatments are intense and impact quality of life.

iv. The aggressive cancers, the ones that truly need intervention, often slip by unnoticed.

The bottom line is that we’re overtreating the wrong ones and missing the dangerous ones.

I started a company with three unbelievably talented scientists four years ago to fix it and we’re making a lot of progress. The company is called @EarlyisGood and if you want to stay informed about high quality cancer screening, please follow us.

WRT prostate cancer, we’ve been working with the Mayo Clinic to build a better test.

It’s a simple urine test.

No blood draws, no rectal exam, and it’s designed to detect only the cancers that actually need treatment.

Most urine tests out there still suffer from the same problem as PSA: they can’t accurately tell which cancers are dangerous. That is because they look at one type of signal. That’s why they’re noisy and unreliable.

Our test looks at both proteins and RNAs. Proteins tell us what’s happening in our body right now. RNAs show what’s coming next.

Together, they give a much clearer signal, so we can accurately tell which cancers are serious and which aren’t.

This is possible because of a set of breakthroughs that came from our cofounders post doc research.

Using her approach, we are able to detect multiple analytes (DNA, RNA, and proteins) at once, directly from urine.

And this is just the start.

We also already have a bladder cancer test in final validation. Next up: leverage our multiomic platform to create smarter, more accurate tests for many diseases.

[Early is Good @EarlyisGood]

Bladder cancer is highly recurrent. Patients need better monitoring tools.

With a $1.6M NIH grant, Early is Good is advancing BCDx—a multi-omic urine test to detect recurrence early, non-invasively.

Thank you, NIH, for supporting this important need.

[GenomeWeb @GenomeWeb]

NIH Awards Early is Good $1.6M for Bladder Cancer Monitoring Test https://t.co/dvVPJtwMvV

[INBiosciences @INBiosciences]

Congratulations to @EarlyisGood on the news of its new collaboration with @MayoClinic. This vital collaboration will help to advance cancer care through improved detection and treatment selections for prostate cancer. https://t.co/BrY1ByCifx

[National Comprehensive Cancer Network (NCCN) @NCCN]

Saturday morning at the #NCCN2024 Annual Conference included a plenary session on the Impact of Drug Shortages on Cancer Care, information on Appropriate Vaccinations for Patients in Survivorship, poster tours, and more.
Tune in: https://t.co/LAQT1Wmrpm

[Early is Good @EarlyisGood]

We are excited to welcome Dr. Eric Kim as our Vice President of Clinical Sciences.

Dr. Kim is a uro-oncologist at Washington University, specializing in bladder, kidney, and prostate cancers with extensive research work in imaging and biomarkers.

His understanding of the unmet needs in the patient’s cancer journey from diagnosis through treatment selection, along with his expertise in clinical trials will greatly advance EIG's mission of creating diagnostics for early accurate detection and improved treatment of cancer. #earlyisgood #urology #oncology #bladdercancer #prostatecancer

[Early is Good @EarlyisGood]

#LifeScienceSummit2023 has put a spotlight on the importance of #earlydetection. Impressive to see #Indiana at the forefront of this vital movement, leading the way in preventive healthcare.

[Jay Z @superjz]

Excited to see this come to life @EarlyisGood, @thaksuper!

[Chamath Palihapitiya @chamath]

Small cancer breakthrough alert:

Three years ago we cofounded a company to improve the detection of cancers using a nanotechnology that our cofounder had pioneered in her doctoral and post doc work.

Our nanotechnology expands the boundaries of molecular diagnostic tests from single-type multiplex biomarkers to multi-omics multiplex biomarkers.

Multi-omics and multiplex: Simultaneous detection of DNAs, RNAs, proteins, and genes in a single, low-cost test for a comprehensive outlook on a disease.

No extraction or amplification. Blood and urine are used as-is, saving time while minimizing human error and variability.

Unprecedented sensitivity: 10-18 attomolar. Enables the capture of even tumor suppressor markers that are crucial for early detection.

Quantifiable test. Unbiased and objective. No Need for a bioinformatician to analyze and interpret the results.

Affordable & easy to adopt to any lab. Require simple instrumentation without needing highly skilled technicians.

We directed this technology initially at bladder cancer. There are more than 80k new cases in the US each year and almost 600k worldwide. The current standard of care requires a cystoscopy (invasive test) for diagnosis. And then the patient requires a cystoscopy every 3-6 months after they are treated or are in remission.

Our company’s test is urine based, has a high PPV and NPV and can be used to diagnose bladder cancer early as well as prevent unwanted cystoscopies (see image below).

While we start the work to scale this test broadly, we will now start our next R&D effort: to see if we can create the first predictive test for prostate cancer AND make this urine based - no more blood based PSA tests or DREs.

This will take many years but if such a test can be created, it can potentially add a lot of value to men’s health and longevity.

If you find this kind of work interesting and would like to contribute, please consider working with us.

You can find out more here: https://t.co/xb2oVazonm

[Early is Good @EarlyisGood]

@earlyisgood presented the multi-omics detection platform at #acsfall2023. Check out the abstract here: https://t.co/L12diCuM0o

#multiomics #bcdx #bladdercancer #noninvasive

[Early is Good @EarlyisGood]

We appreciate @chamath's recognition of our work on #bladdercancer and our breakthrough technology in disease detection in his latest annual report. Excited to continue pushing the boundaries in #EarlyCancerDetection.

Earlier Detection. Better Outcomes.

@socialcapital @superjz

[Chamath Palihapitiya @chamath]

Annual letter drop… 2022 edition

--Returns
--What the hell is going on (end of ZIRP, Ukraine, re-rating growth assets)
--How we think about the future
--Portfolio update
--SPAC post-mortem

Read it here: https://t.co/FCISD3mhw6

[INBiosciences @INBiosciences]

Congratulations to IBRI Member @EarlyisGood! They just secured $4 million in seed funding to continue work on the early detection of renal system diseases. https://t.co/KSk9tDyGfZ

[Bladder Cancer Advocacy Network @BladderCancerUS]

We wish your well, Mr. Bradshaw. Thank you for having the courage to publicly disclose your #bladdercancer journey. #TerryBradshaw