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BillionToOne Is Solving One of Biotech’s Hardest Problems
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1 in 11 babies born in America this year will be screened by a genetic test that didn't exist a decade ago. Biotech startup BillionToOne turned a simple but radical idea—detecting rare fragments of fetal DNA in a mother's blood—into one of the most widely used prenatal tests in the U.S. And they're not stopping there. The same approach could unlock something even bigger: early-stage cancer detection from a blood test, a breakthrough that could one day save millions of lives. In this episode of Hard Tech, YC's Jared Friedman sits down with David Tsao and Oguzhan Atay to hear how they went from half a lab bench to a $4B biotech company—and why they believe this is just the beginning of what their technology can do. Learn more: https://www.billiontoone.com Chapters: 00:00 – Finding One Mutation in Billions 01:00 – Detecting Disease From a Blood Sample 02:10 – From Lab Idea to $4B Company 03:05 – The Breakthrough That Made It Possible 05:15 – Building the First Test From Scratch 07:30 – One Customer and a Sales Crisis 08:55 – Inside the Lab: How It Actually Works 12:10 – Detecting Cancer From Blood 13:50 – The Path to Early Cancer Detection 16:05 – Why Early Cancer Detection Is So Hard Apply to Y Combinator: https://www.ycombinator.com/apply Work at a startup: https://www.ycombinator.com/jobs
Segments Timeline
Finding One Mutation in Billions
"One in 11 babies born in America this year will be screened by a genetic test that didn't exist a decade ago. Can you articulate like the needle in the haystack problem that you have to solve? There a..."
Detecting Disease From a Blood Sample
"we would have solved the, you know, holy grail of cancer detection. >> Billion to one was built by two PhD students who started with half a lab bench and $300,000. So how did they pull it off? And wha..."
From Lab Idea to $4B Company
"it releases its DNA into the bloodstream. By detecting this DNA, we can develop diagnostics that have been impossible even a decade ago. >> And all their hard work is paying off. Late last year, they ..."
The Breakthrough That Made It Possible
"could only be detected via amnneocentesis an invasive procedure that is only used in high-risisk pregnancies. What was the key insight that enabled you guys to do this when no one else was able to do ..."
Building the First Test From Scratch
"years of the company and talk about how you went from PhD students who had a cool idea to an actual commercial test that was live and processing samples from real patients. Tell us about how you did i..."
One Customer and a Sales Crisis
"friends who was also doing a startup. It was a struggle even to get very common kind of chemical suppliers to allow us to buy things from them because they'd be like, "Well, do you have a bank account..."
Inside the Lab: How It Actually Works
"physicians, we can convince them. But we are not getting in front of them. But patients are getting in front of you know physicians. So can we get you know marketing leads >> and essentially convince ..."
Detecting Cancer From Blood
"with a specific sequence that belongs to that sample before you combine them. So when you look at the data every time you see that barcode you know that that sequence belongs to this patient. >> So he..."
The Path to Early Cancer Detection
"oncology side it would have been far more difficult to achieve that initial successful commercialization that gave us more resources to be able to build, you know, new tests and improve the existing t..."
Why Early Cancer Detection Is So Hard
"all directly report to David and me and they own end to end development of an entire product and they can do that because again they their iteration cycle is so fast and they are not blocked by any bu..."