Ion Genomics Podcast

Grail’s Galleri blood-based cancer detection test appears headed towards approval by the FDA after it passed a trio of votes from an advisory committee Sept. 23. However, a closer look at the votes — especially the split vote on the question of efficacy — and the debate that preceded it revealed just how much remains unsettled about what the test achieves. As this is the first test of its kind, with more to follow, how FDA chooses to regulate multiple aspects will reveal a lot about where the field is and what it still may need to prove.And it may be the last chance science-minded regulators have to put some reins on Galleri before it gets out into a world where Grail has used its money and influence to tilt the market in its favor. Alex Dickinson, a former Illumina executive who has built a large following on LinkedIn, in part due to his sharp critiques of Grail and Galleri, joined me to break the situation down.Show NotesAlex Dickinson’ LinkedIn FeedOpenOncoGilbert Welch STAT Op-edhttps://www.statnews.com/2026/10/06/grail-multi-cancer-screening-test-criticism/AdCom Vote Explanation Segment Transcript, including Dan Swerdlow's quote on the burden of Galleri on the US healthcare systemhttps://www.iongenomics.bio/p/raw-reads-grail-galleri-fda-adcom?r=3ihla5My story for GenomeWeb on Grail disclosing that the NHS-Galleri trial not meet its primary endpoint (Paywall)https://www.genomeweb.com/cancer/grail-fda-plans-undeterred-after-nhs-galleri-mced-trial-misses-primary-endpoint/David Cameron NHS/Grail/Illumina https://www.bbc.com/news/business-58146567https://www.bmj.com/content/386/bmj.q1706Grail’s $15 million in lobbyinghttps://www.iongenomics.bio/p/grails-15m-lobbying-shortcut-newsletter?r=3ihla5Grail participation in RFK Jr.-linked event, first reported by Bloomberg (paywall)https://www.bloomberg.com/news/articles/2026-09-18/rfk-jr-linked-group-offered-access-to-us-officials-for-paymentAnd also in the Los Angeles Timeshttps://www.latimes.com/science/story/2026-09-22/rfk-jr-linked-group-offered-access-to-us-officials-for-feeNHS Oncologists’ Letter to The Lancet “GRAIL-Galleri: why the special treatment?”  

Episode 13China’s burgeoning biotech and genomics markets make for the ultimate compare and contrast. Like the US, it has regional hotspots, intense competition, and a big company whose success has helped seed a second wave of startups, many of whom are now breaking through. However, the clinical system is both vast and vastly different, marketing approaches can seem stuck in the past, and success abroad — rather than at home — may end up being the difference between making it and getting caught in the churn. That’s according to Matthew Marlowe, who runs BridgCross Bio, a digital publication seeking to provide insight into China’s biotech industry for a Western audience. Earlier this month, Marlowe spent two weeks traveling across China to meet with and discover companies based there. We discuss some of the new tech he’ll be watching and what it means for companies based in the US and Europe, especially Illumina, which has been hamstrung by high-level government policy that has made it difficult to grow revenue there. Make sure to listen all the way through for a new tidbit I’ve extracted about Illumina CEO Jacob Thaysen’s May trip to China at the invitation of the White House. Marlowe is also founder of Genapse, a marketing company for life science companies.

Nicholas Larus-Stone is Benchling’s Head of AI and coauthor of a new benchmarking study putting large language models (LLMs) like Claude and ChatGPT to work redesigning wet lab protocols. The models did just fine, but didn’t blow the Benchling team away. “They can certainly be helpful at certain biological tasks, but they've by no means solved some of the kind of biology problems that people really care about,” Larus-Stone said.That said, he believes that pharmaceutical companies should be spending more on AI usage. That’s just one of several spicier takes we got into in our conversation. Listen for more of Larus-Stone’s thoughts on why benchmarking LLMs is important, how open-source models can be competitive against proprietary ones, how he has fostered cross-pollination between software engineers and scientists by founding Bits in Bio, and whether he likes the term “TechBio.” Show NotesBenchling’s Bench-Bench protocol study white paperBenchling blog post about the benchmarking studyBits in Bio WebsiteBits in Bio 2025 Annual ReportOther AI benchmarking studies From Jure Lescovec’s lab and the Biomni team:Qu et al. “BiomniBench: Process-level Evaluation of LLM Agents for Real-world Biomedical Research” bioRxiv. May 12, 2026.Guo et al. “PromptBio-Bench: Benchmarking LLM-based Bioinformatics Agents for End-to-End Data Analysis.” BioRxiv. June 1, 2026. Other podcast episodes referencedhttps://www.iongenomics.bio/p/ai-agents-are-coming-for-the-lab

Gordon Freedman and I both developed an interest in mitochondria due to our love of cycling and to understand the limits of performance. Whereas I sought to find a racer’s edge by delving into the biology underlying endurance sports, Freedman sought answers to a simpler question: Why can’t I push as hard as I used to be able to?Follow us down the rabbit hole to a world where there are multiple genomes to consider — one of them bacterial in nature — and a dearth of experimental tools has made it hard to connect mitochondria and their functions to other questions in biology and health. But there’s also hope that by connecting mitochondria to research areas such as cancer and neurodegenerative disease, scientists can peer further into the darkness than they could with only the light of the nuclear genome. Show notes: Gordon’s website, MitoWorldDistribution of pools of mitochondria in skeletal muscle cells. Image credit: Parry et al. Parry et al. “Impact of Capillary and Sarcolemmal Proximity on Mitochondrial Structure and Energetic Function in Skeletal Muscle.” The Journal of Physiology. April 2, 2024. Guo, Y., Xue, Y. Mitochondria as convergence hubs for innate immunity pathways. Communications Biology. (June 8, 2026).Shen et al. “Mitochondria as Cellular and Organismal Signaling Hubs.” The Annual Review of Cell and Developmental Biology. July 8, 2022.IMDB page for A Brief History of Time.https://www.imdb.com/title/tt0103882/

How are people fighting ongoing epidemics using genomics-based technologies such as PCR diagnostics and mRNA vaccines in a world where funding from the US and other rich countries is on the decline? My guest this week, my dear friend and fellow journalist William Herkewitz, has reported on the recent Ebola outbreak in the Democratic Republic of Congo as well as tuberculosis around the world. A former communications director for the now defunct USAID in multiple African countries, he has seen firsthand how funding from the US helped keep people healthy and infectious diseases at bay. We discuss what happens when dollars disappear, and with them, networks of people and trust. We also evaluate PCR, next-generation sequencing, and paper-based diagnostic tests in these remote and resource-limited settings. For more of Will’s reporting, check out The Rift Valley Dispatch, also on Substack. https://www.theriftvalleydispatch.com/Show notes: Will's New York Times Op-ed“Why We Couldn't Sell America on U.S.A.I.D.”“Rollout of 5,000 Near Point-of-Care TB Test Systems in 13 Countries Begins With $50M in Funding,” by Madeleine Johnson