This Startup Wants To Catch Cancer Before It Spreads
In a Nutshell
BillionToOne, founded by two PhDs from a YC 2017 half-lab bench, uses synthetic DNA (QCTs) added pre-PCR to eliminate amplification noise, enabling their widely adopted prenatal test detecting single base pair mutations in fetal DNA from maternal blood—now processing 600k tests/year with 20% market share at $4B+ valuation. The same technology powers liquid biopsies for oncology: already detecting actionable tumor mutations in late-stage cancers, launching ultra-sensitive MRD tests for stage 1 patients within a year, and targeting early detection in healthy populations as the "holy grail" to prevent spread. They scaled via interdisciplinary hiring, small autonomous teams, AI-optimized labs for 2M tests/year, and a phased roadmap (prenatal → late-stage → early-stage cancer) that built revenue before tackling bigger markets.
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One in 11 babies born in America this year will be screened by a genetic test that didn't exist a decade ago. There are 3 billion base pairs in the human genome. In diseases detected from mom's blood like sickle cell disease and cystic fibrosis, usually only one base pair is different. Finding one base pair out of billions is the needle in the haystack problem, origin of the BillionToOne name. Their prenatal test is one of the most widely used genetic tests.
BillionToOne is less than a year away from launching an ultra-sensitive MRD test (minimal residual disease) for stage one cancer patients. The same technology could enable early stage detection before cancer reaches stage one. > Once we are there, technically we would have solved the holy grail of cancer detection.
BillionToOne was built by two PhD students, Oguzan and David, starting with half a lab bench and $300,000. They applied to YC in 2017. Now processing more than 600,000 tests a year with close to 20% market share. Went public late last year at over $4 billion valuation.
BillionToOne is a next-generation molecular diagnostics company detecting DNA in blood samples. Tissues shed DNA into bloodstream, including fetus DNA from mother's womb and cancer DNA as it mutates and grows. This enables diagnostics impossible a decade ago.
Core idea same since 2017 YC application: prenatal genetic test sequencing fetal DNA fragments in mother's blood for universal adoption. Before BillionToOne, detection required amniocentesis, invasive for high-risk pregnancies only.
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