What’s Next in Genomics: Six Trends and Six Tips by Two Visionaries

Illumina For Startups
6 min readJun 24, 2021

Illumina For Startups | Spotlight Article by Marc Martin-Casas, Ph.D.

Through launching groundbreaking genomics solutions and products, Emily Leproust, CEO of Twist Bioscience and Mostafa Ronaghi, former CTO of Illumina and co-founder of Illumina Accelerator, have reshaped the biotech industry for good. In this spotlight article, they discuss their current perspectives on the genomics and the multi-omics space — and where they think the future is headed. They also provide tips for budding entrepreneurs, based on decades of experience building breakthrough startups.

SIX TRENDS FOR STARTUPS:

1. The genomic microscope: driving towards multi-omics

A decade ago, the main tools for interrogating diseased tissue would largely rely on imaging-based techniques. The democratization of genomics and the advent of multi-omics approaches are giving way to a data revolution, as we can now look at cells with exquisite and comprehensive detail. The term “genomic microscope” can be used to describe this new paradigm: a shift toward omics-based tools that can comprehensively interrogate cell behavior and interactions at the subcellular, cellular, and tissue level. The resulting multidimensional datasets will enable increased understanding of the correlation between omics data, biological function, and disease states.

2. The future of genomics-driven medicine is bright — but it is still early days

Genomics is a big disruptor of biological research and medical practice. Despite the recent increase in genomics-based therapeutics and diagnostics, only around 0.1% of the genome is currently actionable. As we advance our understanding of genomic variation and its implications on function and disease, further reduce the cost of sequencing, and unlock novel target classes in coding and non-coding regions of the genome, we can expect the actionability of the genome to increase dramatically. The genome of each individual human being has about 15 single nucleotide polymorphisms (SNP) or mutations that are unique. In order to enable the true personalization of medicine, we will need to elucidate the functional and biological significance of an additional 700 million genetic variations.

3. Monetization of genomics data: how much is a database worth?

The quality of a database (and its value) needs to be appraised from a holistic perspective — the amount and richness of data are as important as sample collection, processing, and analysis methods used in the first place. Collection and analysis methods, if not systematic and thoroughly designed, can introduce significant bias, which will render databases less valuable and useful. Another important consideration concerns the comprehensiveness of databases. The ability to re-interrogate databases containing multi-dimensional, multi-scale sets of information can significantly increase its value.

Because of the ever-increasing affordability of sequencing, the cost of sample collection and preparation might become larger as a fraction of the total cost of genomic analysis. In order to justify the highest data richness and sequencing amounts, it is best to go after a big target market. In biology, there are no two people in a garage making an idea into a billion dollar company — and that is why it is best to go big or go home. A lofty vision and goals will justify thorough and systematic method development to obtain the largest, richest, and highest-quality database.

4. Genomics as first-line diagnostics: the promise of liquid biopsy

Imaging data collection and sharing is not a democratized process — current tools for diagnosing cancer or neurodegenerative diseases are expensive and hard to access. For example, MRIs or CT Scans require going to a hospital and can be prohibitively expensive. Those living in rural areas may not have local access, thus requiring them to travel hundreds of miles to undergo a diagnostic procedure. Liquid biopsy, which consists in molecular-level analyses of bodily fluids such as blood, saliva, and urine, will become first-line diagnostics. Imaging technologies will not disappear but will be significantly disrupted, as they get relegated to second line after a liquid biopsy as an initial screening. A notable example of this paradigm shift is GRAIL, which is poised to radically improve outcomes for cancer patients by detecting cancer earlier when it can be cured.

5. Making it big in genomics — creating a new market or disrupting an existing one

Genomics-enabled technologies are flexible and can have many applications — focusing on the optimal market (and indication) will be a key determinant of startup success. There are multiple ways to think about and carve out a target market — in the tools space, one is selling picks and shovels to enable people that are digging for gold. In the diagnostics space, one is selling tests that are relatively inexpensive to a lot of patients. Conversely, in therapeutics, one is selling drugs that are relatively expensive to fewer patients.

Regardless of the specific startup focus, the articulation of a big market opportunity is somewhat easier if the market already exists and is getting disrupted. Making a believable case for a big market that does not yet exist is substantially harder. An example of an existing market ready to be disrupted is data storage, which is estimated to be worth over $30 billion. Hard drives or tapes are not reliable for storing information in the long term and the cost of ownership is high. DNA synthesis and reading tools can be a big disruptor in the archival storage market by providing alternatives to traditional storage solutions.

6. The COVID legacy — here to stay?

The impact of COVID on the biotech industry has been dramatic. Platform companies have experienced a boom, and biology, infectious diseases, and diagnostics are “cool” again. COVID has effectively brought about an acceleration of business — for the good and for the bad. Some startups have disappeared much faster, whilst others have become more prevalent by making progress much quicker. An illustrative example of this phenomenon is telemedicine, which did not gain much momentum in pre-COVID times despite having received substantial sums of capital. Because of COVID, many doctors are currently seeing patients remotely and we can only expect this trend to continue in a post-COVID world.

From a societal perspective, biology is cool again. People with no biology background are regularly discussing the intricacies of diagnostic accuracy, false positives, and the mechanism of action of different types of vaccines. Prior to COVID, the chatter was primarily around drugs being too expensive. This is a great opportunity to capitalize on — if we can discover, develop, validate, and launch multiple vaccines in 12 months, there is nothing we cannot do. We cannot squander all the goodwill that we have created.

SIX TIPS FOR ENTREPRENEURS:

1. Go all in. Mistakes are bound to happen, but as long as you keep learning and never repeat the same mistakes twice, you’ll be fine.

2. Pick the right team. Choose a co-founder that fits you professionally and personally, and brings a different skill set. At the initial stages of a company, more than 90% of the valuation of the company is based on the co-founding team.

3. Raise today, raise tomorrow, raise every day. Meet investors early and often. Fundraising is the only job a CEO cannot delegate.

4. Go big or go home. Pick a large market that can justify true scientific innovation.

5. Design your fundraising milestones carefully. Seed and A rounds will mean different things for different types of companies.

6. Surround yourself with the best. Stay in regular communication with them.

A look inside the Illumina Accelerator SF Bay Area lab

About Illumina For Startups

Illumina for Startups is focused solely on creating an innovation ecosystem for the genomics industry by partnering with leading venture capital investors and entrepreneurs to create, launch, and grow genomics startups. Illumina for Startups initiatives include Illumina Accelerator, founded in 2014, and Sequoia Capital China Intelligent Healthcare Genomics Incubator, Powered by Illumina, launching Fall 2021. Illumina Accelerator is a company creation engine co-located with Illumina research and development sites in San Francisco Bay Area and Cambridge, UK. Illumina Accelerator has invested in 54 genomics startups from across the globe, which have collectively raised nearly $1 Billion million in venture capital funding.

Illumina Accelerator is accepting applications for the next global funding cycle, which are due by October 1, 2021. Through a single, global application process, Illumina Accelerator will select up to five companies in each location. To learn more and apply, please visit our website.

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Illumina For Startups

Illumina for Startups is catalyzing the global innovation ecosystem by partnering with leading VCs and entrepreneurs to create, launch & grow genomics startups.