Two years ago, GeneDx was teetering. The genetic testing company had laid off 33% of its staff, shares were down 90% from a year prior, and some investors were skeptical of a turnaround plan.
Since then, GeneDx has quietly managed a comeback. Its core business of pinpointing tough-to-diagnose diseases is thriving, the stock has bounced back, and it’s trying to broaden its business by using its genetic and clinical data to help drugmakers hunt for new medicines.
“We’re a small part of the rare disease journey in that we diagnose disease,” GeneDx CEO Katherine Stueland told
Endpoints News
in an interview. “And we’re really turning our attention to how we can work more effectively in the ecosystem and put our data to work in other ways.”
Those “other ways” include discovering drugs, which might be the most intriguing idea — and the hardest. Companies have long used genetic findings as the springboard for new medicines, but GeneDx is betting its data will provide a surer path. The strategy has echoes of 23andMe, a genetic testing company that has struggled to pivot to medicine.
Like 23andMe, GeneDx is helping drugmakers find new targets and refine their approaches. Unlike 23andMe, GeneDx hasn’t sought to develop its own drugs.
The plan to help discover drugs began with GeneDx’s core business of finding mystery ailments afflicting children. Unlike other companies that test broad populations to hunt for known diseases using a small menu of genetic markers, GeneDx sequences a patient’s whole genome or exome, the part responsible for many genetic diseases.
Results are run through the company’s database, which includes genetic and clinical data from hundreds of thousands of rare disease patients. Once a diagnosis is found, patients often contend with a harsh statistic: An estimated 95% of rare diseases lack a treatment, according to the advocacy group Global Genes.
GeneDx connects patients to clinical trials or resources to jump-start medicines. But the company realized it could go further by letting drugmakers tap its rich database for leads.
Last month, the company launched a new offering, called GeneDx Discover. It’s a searchable version of its database that can zero in on variants that drive rare conditions, and maybe even common ones. GeneDx has placed a molecular bullseye on so many mutations that its data could tease out the drivers of a wide set of diseases.
For GeneDx, drug discovery is more of an opportunity right now than a major source of business. But if successful, the company could go from a comeback story to a much bigger force in the rare disease field.
23andMe is the highest-profile example of a genetics company that developed a huge dataset and then tried to pivot into becoming a therapeutics company. The idea was perhaps most appealing when drug developers were just starting to unlock genetic information to create precise new drugs.
23andMe’s tests, which are primarily marketed to consumers, look at just a small part of the genetic picture. The company analyzes DNA misspellings called single nucleotide polymorphisms, or known as SNPs.
Harvard geneticist George Church, who advised 23andMe from 2008 to 2015, recommended that the company seek more in-depth genetic data. But during this time frame, the cost was prohibitive, and 23andMe found itself locked into its business model of detecting ancestral origins and some health conditions.
“They just kept doubling down on the SNPs because they were inexpensive, and they did have first-mover advantage,” Church said in an interview.
After stalled growth and growing expenses, 23andMe announced in November that
it was closing its therapeutics division
. But the company is still helping companies find new drug targets, and seeking partners for its two drugs in clinical trials.
23andMe’s power could prove to be in aggregating data from millions of people. High-resolution genetic data aren’t always as critical when targeting more common diseases that stem from a variety of interacting mechanisms.
“We are a big supporter of GeneDx, and believe their comprehensive database focused on rare diseases is complementary to 23andMe’s large-scale genetic dataset,” 23andMe said in a statement.
Mahzi Therapeutics, a company focused on neurodevelopmental disorders, used GeneDx to develop three of its rare disease therapies that are at the preclinical stage. The company knew the conditions it wanted to target, but GeneDx’s database provided a closer look at the genetic underpinnings.
“We need to understand the targets on the gene. By getting exome or genome data, we have much more information,” Mahzi CEO Yael Weiss said.
But detailed genetic information is far from a panacea. Even when a genetic variant is linked to a disease, it can still be difficult for drug hunters to hit a designated target.
GeneDx’s database also allows drugmakers to find links between genotypes and phenotypes, the physical manifestation of genes. An understanding of the relationship helps drugmakers understand which variants to correct and helps in testing compounds.
“GeneDx offers a different approach because there’s a lot more information than just the genetic sequence. There’s a lot of clinical information,” Weiss said.
The company’s data are aggregated and de-identified. Patients must give the OK for drugmakers to access deeper levels of information, like their genomes. With an explosion in genetic data and accompanying privacy concerns, GeneDx’s website says the company uses “a range of physical, technical and administrative safeguards to secure personally identifiable information.”
GeneDx isn’t alone in trying to spark new drugs from large datasets paired with high-resolution data.
Regeneron sequenced exomes and genomes from more than 1.5 million people and notably found genes that appear to protect against obesity. The company seized on the discoveries to
develop potential weight loss medicines
.
“We really think you need to look at millions of people, even for the common diseases, to find these unique things that could really dramatically change your outcomes,” Regeneron’s chief genomics and data science officer Gonçalo Abecasis said.
Companies are also layering in data from other
sources like the proteome
, the body’s collection of proteins, to find new medicines and diagnostics.
GeneDx was founded in 2000, around six years before 23andMe, by two National Institutes of Health scientists aiming to diagnose rare conditions. As it grew, it expanded into testing for everything from Covid-19 to reproductive health issues to breast cancer.
In 2022, the artificial intelligence company Sema4 acquired GeneDx and the new owners urged focus. The company was unprofitable and part of a diagnostics trend of “trying to be all things to all people,” Stueland said.
After much introspection, GeneDx laid off 700 workers and zeroed in on its original mission of diagnosing rare conditions.
Investors didn’t initially love the moves. GeneDx’s stock plummeted to the point where the company last year was almost kicked off the Nasdaq market.
“It was a daunting experience to decide where to focus,” Stueland said. “But it became super-clear to us as a management team, to us as a board, that we were going to deploy capital towards the area where we had the distinct strength.”
Since then, the company has tapped into growing demand at hospitals for pediatric DNA sequencing. The increasing evidence for comprehensive testing has differentiated GeneDx from 23andMe in another way: getting paid.
Increasingly, insurers and government health programs cover GeneDx’s tests. With more ordering of the company’s genome and exome tests, GeneDx recently reported $77 million in quarterly revenue, and reached profitability for the first time. It now has 900 employees, is the leading player in the niche market, and its stock trades north of $75 a share.
Newborns typically have their heel pricked for blood to find up to 50 genetic diseases. But the testing misses thousands of other conditions, often rare or ultra-rare ones that aren’t known to many doctors and don’t make it into those tests. On average, it takes rare disease patients six years to get diagnosed, what’s known as the diagnostic odyssey.
GeneDx finds answers through not only comprehensive genetic testing for patients, but also by testing their parents and collecting doctor notes for more genetic clues.
Results are checked against its database with 700,000 samples. Once a disease is pinpointed, those data help find the next diagnosis.
“We’re doing the really hard job of going into each and every gene to search and identify a mutation that is causing the underlying disease,” Stueland said.
Stock analysts expect more growth because the company has just started to crack the newborn testing market. It’s a chance to move from sequencing the relatively narrow number of young patients with signs of illness, to a far larger group of healthy newborns.
The company is part of research that found 3.7% of the first 4,000 newborns who underwent whole-genome sequencing had a positive test for a genetic disease, but most of those diseases weren’t included in a list of diseases that are currently screened for. That study, called Guardian, was published in October in
JAMA
.
GeneDx has found that some common diseases are a constellation of genetic diagnoses. That could be useful for drug discovery purposes, along with another aim. The company wants to diagnose Parkinson’s and other conditions earlier, though it hasn’t detailed plans in this area.
“We’re really placing a bet on our ability to be really great at taking a genome’s worth of information and putting it to work for as many people as possible,” Stueland said.