I agree that an individuals polyps situation is not directly relevant to growth stocks, but EXAS (the Cologuard company) has been a monster growth stock as I’ve posted about many times here. It doesn’t get much love on this board, but it enjoyed over triple digit growth for 2-3 years, until just recently coming down under triple digit (as happens with any company showing triple digit for so long).
And as I’ve pointed out, they have multiple catalysts for continued growth:
Recommendation that colon cancer screening start at 45, instead of 50 years old, increasing their TAM.
Promising advances in early detection of liver cancer by liquid biopsy.
Collaboration with Pfizer to promote/sell Cologuard tests started this quarter (the catalyst to have the soonest impact on their numbers).
I’m an owner and have continued to increase my position as the price has gone up (and down) and back up again. And although not why I own it, I think it also has a decent chance of being acquired.
Cologuard is a screening test. If you test abnormal, you get invasive testing.
Guardant 360 tests which gene’s to target for known cancer diagnosis. Now it could replace biopsy if there is a know lung mass. We’re not there yet and that’s something to watch.
Omni has a larger library they test for and are marketing no this for pharma R&D.
Lunar 1 is for follow up testing (you had a lung resection, do you need further treatment? You had 5 years of XYZ cancer treatment, do you need more or less?) … This is not being sold yet.
Lunar 2 is for early detection/screening of high risk individuals (which will surely eventually have indication creep over time!)… there is no product out for this yet.
Issues / points to make:
-Cologuard does not compete with guardant until lunar2. It took YEARS for cologuard to crack the market. Lunar2 will need much more time; and besides, who will order this test? You’ll need significant interaction between primary care and oncology, which is not a guarantee.
-omni and 360 are the fuel that drives research for lunar 1/2. That’s the golden goose. But yes, IF lunar 2 has good data, and IF they have successful marketing, and IF they fend off competitors, Cologuard loses market share. That’s several years away and requires lots of chips to fall into place. It will likely happen eventually, just much further away than we think.
You’ll also have FMI and GRAIL to compete with. Something to watch, but definitely deeper pockets out there. I don’t know if ILMN has much experience marketing to PMDs or not, so that’s one potential leg up I guess.
Will also be interesting if this is a winner take most space or not. My guess is that it’s winner take most.