🩸
Pitch Deck · Totiomics, Inc.

Cell-Free DNA for Immunotherapy Response Prediction

A blood-based platform to identify responders at diagnosis - now validated in a completed Phase 1/2 clinical trial - improving trial efficiency and building the data layer for next-generation immuno-oncology.

Real Data
Completed LUD2015-005 Phase 1/2 Clinical trial
Earlist Predictor
Predict response at diagnosis instead of day 90 by imaging
Max Survival
80% 24-month survival probablity instead of 25%
The Problem

We are flying blind during immunotherapy

⏳
Too Slow
Standard CT imaging cannot determine response until 3 months into treatment - after multiple costly cycles.
🎭
Pseudoprogression
Tumour flares on imaging can mimic progression, leading to premature treatment discontinuation in up to 10% of patients.
💸
Wasted Resource
Only ~30% of patients respond to immunotherapy. Delayed detection wastes ≥$120K per patient in ineffective treatment.
🔬
There is no widely accepted and clinically validated tool that can tell an oncologist - at diagnosis - whether a patient will likely responde to immunotherapy. Totiomics has that tool.
The Science

cfDNA dynamics mirror tumour biology in real time

What is cfDNA?
Cell-free DNA (cfDNA) - including circulating tumour DNA (ctDNA) - is shed by dying tumour cells into the bloodstream. A simple blood draw captures a real-time snapshot of tumour burden.
Immunotherapy signature
Effective checkpoint inhibitors trigger rapid tumour cell death, producing a measurable ctDNA spike then decline within 2 weeks - far ahead of any anatomical change visible on imaging.
Our multi-modal approach
We integrate ctDNA variant allele frequency, fragmentomics, methylation signatures, and a novel T-cell cfDNA signature - first described in our LUD2015-005 AACR abstract (PR017) - to build a composite response index with superior sensitivity.
Response timeline comparison
ctDNA Responder Signature (Totiomics) Day 0
ctDNA Response Confirmation ~Day 15
Clinical symptom change ~Day 90
Source: LUD2015-005 Phase 1/2 trial data
≈ 3 months earlier - confirmed in LUD2015-005
For metastatic patients, with 6 month median survival time in esophgeal cancer, predicting response 3 month ealier is life or death.
Our Solution

The Totiomics Response Index (TRI)

🧬
Layer 1: Mutation
Ultra-sensitive ctDNA variant allele frequency tracking using error-corrected sequencing (UMI-based). Detects down to 0.01% VAF.
✂️
Layer 2: Fragmentomics
Tumour-derived cfDNA fragment size profiles and nucleosome positioning patterns reveal immune-mediated cell death signatures.
🧲
Layer 3: Methylation
Tissue-of-origin methylation deconvolution resolves immune cell cfDNA from tumour cfDNA - capturing both sides of the response.
🦠
Layer 4: T-cell cfDNA Signature ★ Novel - AACR 2024, Abstract PR017
T-cell-derived cfDNA fragments in plasma carry a unique chromatin accessibility and methylation signature reflecting tumour-infiltrating activity. Identified in our LUD2015-005 oesophageal cancer trial (durvalumab ± tremelimumab), this layer stratifies patients into immunotherapy responders with 80% 2-year survival probability and non-responders with only 25% 2-year survival.
Blood draw
Standard EDTA tube, day 0 + day 15
TRI Score
Composite index: 0 (no response) → 100 (deep response)
Clinical report
Delivered within 5 business days, integrated with trial EDC
Market Opportunity

Three large, addressable markets

$4.2B
Clinical Trials
Companion biomarker testing for pharma / biotech immuno-oncology trials. TRI-as-a-service: $3,000–5,000 per patient sample set.
$2.9B
Clinical Diagnostics
LDT and IVD pathway for clinical response monitoring in routine oncology care. 1M+ patients initiated on immunotherapy annually in the US alone.
$2.1B
Data & Licensing
Longitudinal cfDNA + outcome dataset licences to pharma, AI drug discovery platforms, and academic consortia.
Immuno-oncology global market
$150B
by 2030 (CAGR 14.2%)
Liquid biopsy market
$2.9B
by 2030 (CAGR 18.5%)
Totiomics SAM (Year 5)
$350M
trials + diagnostics
Competitive Landscape

We combine what no-one else does

Company ctDNA Mutation ctDNA Methylation Baseline Test Multi-omic AI-Integration
🔵 Totiomics ✅ ✅ ✅ ✅ ✅
Foundation Medicine / Roche ✅ ❌ ❌ ❌ ❌
Guardant Health ✅ ❌ ❌ ❌ ❌
Grail (Illumina) ❌ ✅ ❌ ❌ ❌
Natera (Signatera) ✅ ❌ ❌ ❌ ❌
💡
Our moat: Multi-modal integration - including our novel T-cell cfDNA layer (AACR 2024, PR017) from LUD2015-005 - is computationally non-trivial. Our proprietary TRI algorithm, trained on >600 treated patient samples, cannot be replicated by adding a single assay layer to an existing product. No competitor captures the immune arm of response from blood alone.
Business Model & Go-To-Market

Pharma-first, then clinical deployment

Phase 1 (2026–2028): Pharma partnerships
Embed TRI as a mandatory exploratory biomarker in immuno-oncology clinical trials. Charge $3,000–$5,000 per patient per timepoint. Target: 5 pharma partnerships, 500 patients. $2M ARR.
Phase 2 (2028–2029): LDT clinical lab
Launch CLIA/CAP-certified lab for TRI as a Clinical Laboratory Developed Test for routine oncology monitoring. Target: 2,500 patients/year. $12M ARR.
Phase 3 (2030+): IVD & data licensing
Seek FDA Breakthrough Device Designation and IVD clearance. License curated cfDNA + outcomes dataset to pharma / AI platforms. Target: $50M+ ARR.
Revenue model
Fee-for-service (trials) $3–5k / patient
Clinical LDT $1.2–2k / test
Data licensing $500k–2M / deal
Key milestones
✅ Phase 1/2 trial LUD2015-005 completed - data in hand
✦ Signing LOI with 2 pharma partners (Q4 2026)
✦ Submitting key patents (Q2 2027)
✦ CLIA lab certification (Q3 2027)
✦ FDA Breakthrough Device application (2028)
Traction & Validation

Phase 1/2 trial complete - clinical proof in hand

LUD2015-005 - Phase 1/2 Clinical Trial (Completed) · Oxford Cancer / AstraZeneca
Prospective trial of durvalumab (anti-PD-L1) ± tremelimumab (anti-CTLA-4) plus chemoradiotherapy in oesophageal cancer, funded by Ludwig Cancer Research & CRUK. Blood and tumour tissue profiled with cutting-edge sequencing to identify who responds to immunotherapy. Key finding (AACR 2024, PR017): a T-cell cfDNA signature in plasma predicts immunotherapy response - captured non-invasively from blood weeks before imaging.
📄 Publications & Presentations
AACR 2024 (Abstract PR017) - "A T-cell signature in circulating cell-free DNA" presented at the AACR Special Conference: Liquid Biopsy, November 2024, San Diego. First description of T-cell-derived cfDNA as a non-invasive immune response biomarker from LUD2015-005.

Tumor monocyte content predicts immunochemotherapy outcomes in esophageal adenocarcinoma. Cancer Cell. 2023 Jul 10;41(7):1222-1241.e7.
🏅 Recognition
Our Oxford–Ludwig Institute-affiliated lab joined Cancer Grand Challenges in 2026, receiving a $25 million award over five years for biomarker development.
🤝 Collaborations
Data-sharing with Ludwig Insitute of Cancer Research and University of Oxford. Access to 2000+ additional prospectively samples in upcoming trials.
Financials & Use of Funds

Seeking $8M Seed to reach Series A milestones

Projected revenue (£M)
2027 £0.4M
2028 £2.2M
2029 £6.8M
2030 £18M
Path to profitability: Q4 2029
Use of $8M Seed
Clinical validation (n=300) 25% · $2M
CLIA lab build-out 25% · $2M
R&D / algorithm development 12.5% · $1M
Team & ops 25% · $2M
Series A trigger (24 months)
Phase 1/2 (LUD2015-005) ✅ complete · 3 pharma contracts signed · manuscripts published · CLIA cert obtained · £3M+ ARR
The Ask

Back the platform that makes immunotherapy measurable in real time

We've completed a Phase 1/2 clinical trial (LUD2015-005) that proves cfDNA detects immunotherapy response at diagnosis and we are able to confirm the prediction on Day 15. Now we're raising $8M to turn that clinical proof into a deployable diagnostic platform to save lives and redefine the next decade of immuno-oncology.

🎯
$8M Seed
Targeting close Q4 2026. SAFE note with $40M cap. 20% discount on for first $2M.
⏱️
24-month runway
To Series A milestones: 3 pharma contracts, submitted patent, 300-patient validation, CLIA cert.
📈
10-50X+ exit potential
Comparable: Natera ($4B), Guardant Health ($3B), Tempus AI ($6B IPO).
Ethan Wang - CEO, Totiomics, Inc.
ethan.wang@totiomics.com
www.totiomics.com
Team

Founders & advisors

Founders
Ethan Wang, DPhil Candidate - CEO
Computational & molecular biologist with hands-on experience in biomarker discovery and prognostic model development at Johns Hopkins, Harvard, and Oxford.
Branavan Rudran, MBBS, DPhil Candidate - CMO
Physician and surgeon with clinical trial experience in data-driven patient stratification and expertise in medical imaging technologies.
Academic & Financial Advisors
Xin Lu, PhD - Academic Advisor
Professor of Cancer Biology at University of Oxford. Current director of Ludwig Institute of Cancer Research at Oxford branch.
Leo Wang, MBA - Financial Advisor
Seasoned financial expert in global markets and AI-driven transformation. Current global head of EFI at HSBC.
Why this team wins
✦
Deep domain expertise across cfDNA, immunotherapy, and clinical trials
✦
Track record translating multi-omics research into deployable tools
✦
Strong connections to cutting-edge tech and pharma partners for pilots and trials
1 / 11