[00:13] expanding or improving and developing our technologies and abilities to detect our technologies and abilities to detect cancer. And if we can find a way that can detect all these cancers and more by a simple blood test for example, that
[00:29] definitely will make all of this more feasible because going in for a blood test and in labs is definitely way more manageable for the health care system versus oh, making everyone get a
[00:41] system versus oh, making everyone get a colonoscopy for example. And this is why why another reason this was another reason for us to put this together and focus a lot on multi cancer detection through blood assays, blood based
[00:54] assays. >> Okay, and I think that would be a good that. So, Palm Health offer different ways for people to be can get their cancer screened
[01:08] uh with the concierge service. Uh and one of the things that you use is this multi multi cancer early detection blood uh blood base system. And I think it's called Gallery. Is that
[01:20] how you pronounce it? Gallery. So, could you talk about how that works? What are you looking for in the blood in terms of um cancer? >> Mhm.
[01:32] Yeah, that's a great question. So, um in our uh company our actually our company is basically an online platform that connects people who don't have really a cancer diagnosis necessarily. Uh they're just um healthy people who
[01:50] Uh they're just um healthy people who are interested in making sure there's uh that first of all knowing their of cancer in general, and second of all, detecting if there's anything already brewing that's not apparent yet. Because
[02:06] brewing that's not apparent yet. Because as you know, in most cancers at stage one, they it's asymptomatic usually, and that's why people miss it and don't feel anything and until it's already too late when the cancer has
[02:20] already developed and progressed and started causing symptoms. And so, what started causing symptoms. And so, what we do is we you get an appointment with an oncologist really, which is another benefit that people also who without a
[02:34] cancer diagnosis don't have. So, you know, you in the real world you don't really see an oncologist until you have a diagnosis of cancer. Because you know, the first barrier or the first uh
[02:49] I don't know if I want to call them first responders basically or the first before you take the next step is basically your primary care physician. And those are usually the doctors who
[03:02] screen for cancer or detect cancer or suspect a cancer and then they refer you to an oncologist where you come in with a diagnosis of cancer and take it from there. So, you don't you can't really get an
[03:14] appointment with an oncologist just to talk about cancer and be screened for cancer and see what options you have. So, this is the first thing. So, you get to speak to an oncologist, talk about your cancer risk and everything, and
[03:27] we go over the tests that we do. So, the majority of our tests are blood-based, majority of our tests are blood-based, and one of them is the Galleri test from And that is in addition to a number of other blood-based assays or tests, but
[03:42] those include some of the traditional tests which are the basics, and of course before you jump onto the more advanced you can sometimes find things with just a regular CBC and a metabolic panel. So,
[03:56] that's definitely included. There's a a number of cancer markers that are also known to be produced in the blood produced in the blood like CA 15-3, CA 125, CA 27.29,
[04:11] And so, these markers are known to be produced by cancer cells as well. And so, they are included in our panel.
[04:23] of the panel which looks for blood cancers the panel which looks for blood cancers as well in the blood. And we do have urine tests that can look for signs of bladder cancer as well
[04:39] or another type of blood cancer called multiple myeloma that secretes proteins that can be dumped into the urine. And we have also an imaging option. And like
[04:51] CAT scans are not great because they have radiation. So, in our case, we go have radiation. So, in our case, we go for an MRI which is magnetic waves which don't really have a risk of inducing cancer in your body. So, that is also
[05:06] another way of um having a full picture of the body. And so, going back to your question about Galleri, so that is a blood-based assay and it's it looks for DNA methylation
[05:21] um a process that where the body actually or the cells to be more exact methylate pieces of DNA to in order to press
[05:33] certain genetic markers or certain proteins that aid the cancer cells in their survival and proliferation. And so, what GRAIL has done uh, in the past
[05:46] was it looked at a lot of different, uh, types of cancers and or patients with different types of cancers and looked at the blood and looked at, uh, DNA that's floating around in the blood.
[05:58] Uh, because we know that cancer cells can shed DNA. And they found that can shed DNA. And they found that different cancers have different signals different cancers have different signals or, uh, signatures on their DNA. So, DNA
[06:13] being shed from lung cancer has a different, uh, methylation signature on different, uh, methylation signature on the DNA versus DNA being shed from kidney cancer or DNA shed from colon cancer. And so, they looked at the DNA
[06:28] or methylation signatures from different cancers and were able to make associations. And so, now what they do, they and they made a list of 50 cancer subtypes. And now when we do that blood test, they look for these different
[06:43] signatures that they previously identified. And if they detect any of that, then they tell you, "Okay, you have a cancer signal in your blood that seems to be corresponding to lung cancer, for example." And so,
[06:59] when that result comes back, you take the next step, which is looking for lung cancer, which would involve imaging. And so, this is really how Galleri works. But, because it's it only covers 50 cancers, that's why we included a
[07:16] much bigger panel of, uh, assays uh, that we combine together in, that we combine together in, uh, a single blood draw. When we, uh, go to, because we partnered with Quest, so you go to a Quest lab and you just get
[07:30] all those tests drawn in in one setting. And so, when the results come back, they come to, uh, the oncologist who goes through them and then connects with the patient again. Of course, based on the results, you can discuss
[07:44] the next steps. Uh and so far, of course, uh we've had Uh and so far, of course, uh we've had both situations happening. So, pe- some people go through all the tests and everything comes back completely
[07:57] patient, tell them everything looks good. And then, a few cases where um things came back concerning for a few um things came back concerning for a few things and um we talked with them and
[08:11] told them about the next steps. So, one of them already was able to uh find uh an oncologist to take the next steps of diagnosis because
[08:23] you know, our job is to detect the cancer and then guide you with uh next step. So, um because this is a telehealth virtual um service, you can't be a treating oncologist. So,
[08:39] uh because we we I I could be here in Massachusetts and then I have I'm talking with a patient from California. I can't treat them from here. So, we our uh detect their cancer and then connect them with a local oncologist who can
[08:56] uh start the treatment or do extra tests that are needed before they can begin treatment. And so, um in one case, a patient already was able to directly patient already was able to directly find someone and started working on uh
[09:11] further identifying the cancer with them, a blood-based cancer. The another patient that I is coming to my mind, actually, we were able to connect with them uh and uh talk with their primary care who's
[09:27] going to do referrals to doctors in uh to a doctor oncologist in their area. So, we take the first step and then we guide you through the next steps um until basically you find someone who can also
[09:41] take over management of whatever we find in terms of cancers different cancer subtypes. >> Okay. So just thinking about Gallery. So so Gallery you're looking in the blood,
[09:55] right? So it it has to be a tumor that has blood flowing through it or and also will it catch I think it will catch the cancer potentially earlier than
[10:10] where you know the cancer has to get a bit more developed before it becomes noticeable. >> Yeah. >> So that's right. So
[10:24] because it's a blood based assay of course the cancer needs to have blood flow through it and that is the case for most cancers really and that's the benefit of
[10:37] That plus any other blood based assay really. And that is basically the least invasive way right now to to try and detect all those cancers. You know, it's definitely
[10:50] still not perfect because you know, there's always cases of cancers that might not secrete anything at all and that's why Gallery doesn't detect all 200 cancers, right? It it has a list of 50 and that's why we
[11:06] It it has a list of 50 and that's why we add on top of it other blood assays and urine and even stool and in general a whole body scan too and in general a whole body scan too with MRI. Sometimes you know, either the
[11:21] cancer doesn't secrete anything at all even if it's known to secrete something even if it's known to secrete something and you know, there are some cases that are not so common but they can happen because nothing in medicine is the same
[11:37] all the time. It's a spectrum. So, even though we know, for example, that colon cancer secretes uh CEA, you might find a few cases where that that's not happening really. Where their cancer is mutated in a way that
[11:53] just doesn't secrete that protein into the blood. And so, even if the blood flows through it, it's still not secreting it. And that's why them yes, blood is the best way or the least
[12:07] invasive way to catch these things, but it's still not perfect. And of course, there could still be um false negatives. So, it's not uh 100% accurate all the time.
[12:21] Uh but at least we are getting as close to 100% at least we are getting as close to 100% accuracy as possible. And that is why we use multiple modalities to overlap um different cancer diagnoses, so we
[12:35] don't fully rely on just one thing only. Because even when we do Gallery, we're still looking, for example, for CEA in the as a traditional test. And
[12:47] Gallery, for example, looks for the methylation signature for colon cancer. And if you do the imaging, you're also looking at the colon. So, you have three ways to really catch the colon cancer rather than just relying on one. And all
[13:04] of them are not really invasive compared to a colonoscopy. Um where you know, there's risk of bleeding, there's risk with the anesthesia. So, you know, uh it's it's definitely different.
[13:19] uh it's it's definitely different. >> [music]