The golden rule in marketing and communications is “speak to people the way they want to be spoken to”. This is exponentially harder than following The Golden Rule “treat people the way you want to be treated” because you are not an accurate reference point. What matters is exposure to and observation of those who care about a topic – enough to understand why they care, so you can speak to them, and not around them.
Over the last decade, HDMZ has worked with a range of leading molecular residual disease (MRD) and cancer surveillance-related companies facing this challenge. Communicating the value of an MRD test is particularly hard because there are so many stakeholders with different whys. Surgical oncologists care about MRD tests for different reasons than medical oncologists, who differ from clinical developers, who differ from patients, regulators, NCCN guideline committees, trade media reporters… and on and on. And there is meaningful variation within each of those groups as well.
What follows is some of our experience speaking to the whys of MRD stakeholders; and what often does or doesn’t connect.
The patient wants better quality of life
Ask a patient what makes an MRD test attractive, and they reflect on how it changed their experience of living with cancer. A better experience looks like a simple blood draw covered by insurance; a result that tells them clearly whether cancer is detected; a clinician who knows what to do next; and next steps that align with their priorities and risk-tolerance.
However, patients have little tolerance for ambiguity, which is challenging because MRD results are probabilistic. A negative result does not mean cancer-free, and an increase in MRD does not necessarily mean treatment isn’t working. Communicating about a test accurately, in a way that informs rather than distresses, is a major challenge. It requires close collaboration, health literacy and experience with regulatory-compliant writing.
The clinician wants outcomes data…then ease of use
Ask a clinician, and the answer is deceptively simple: “Show me it improves clinical outcomes, and make it easy to use”. Specifically, clinicians want to see that a test statistically improved patient outcomes in a clinical study. Conflating analytical performance or even clinical validity with clinical utility is a costly error, and requires precision in language that can feel constraining but is crucial for successful marketing.
Somewhat counterintuitively, clinicians are often ambivalent about the underlying technology of an MRD test. They may be specialists in their field, curious and well informed, but that doesn’t mean they want to learn the difference between “tumor-informed” and “tumor-naive”. They do care that the tests they use are effective, trusted and integrate easily into their decision-making and operational infrastructure.
We have watched companies invest substantial time and budget trying to win clinicians over with technical differentiation, only to find that the message lands on deaf ears. One company we worked with initially built their entire go-to-market around a proprietary detection technology. When they realized clinicians were not engaging with that message, they pivoted – leading instead with test performance and MolDx coverage. The shift was transformative.
The clinical developer wants a research partner
A cancer drug developer’s why extends beyond the test to the quality of partnership they can expect. Clinical developers are eager to employ MRD tests in clinical trials because they can give trials the statistical power to prove efficacy in earlier-stages of disease. MRD’s superior sensitivity to cancer when compared to imaging enables trials to enroll patient populations at earlier signs of recurrence, and monitor therapeutic response with better resolution.
The qualities of an MRD test are important to make these trials possible, but so is the nature of the partnership with an MRD company. For instance, an MRD company may provide access to pre-established relationships with principal investigators, who can make the difference between a trial that enrolls on schedule and one that doesn’t.
Upfront alignment and long-term collaboration between drug developers and test developers is also necessary to ensure a trial meets regulatory and payer expectations, particularly if the MRD test is intended for use as a companion diagnostic or surrogate endpoint. Generating the data to support FDA approval of a companion diagnostic or validation of a surrogate endpoint requires deep pockets and commitment from the biopharma partner and the MRD company.
Recent approval of Signatera as the first MRD companion diagnostic is a landmark in this respect: it establishes a precedent that the entire sector will reference, much as Foundation Medicine’s approved panels shaped the companion diagnostic landscape for comprehensive genomic profiling. To date no MRD test has yet been formally qualified as a surrogate for accelerated approval in solid tumors, but FDA guidance on ctDNA as a surrogate endpoint published in 2024 signals increasing openness to that application.
Clinical guidelines developers want established clinical practice
NCCN and analogous guidelines bodies are generally the most delayed signal of support for an MRD test. They follow clinical practice rather than lead it, and the bar for inclusion is high: prospective, robust evidence at the level of Category 1 or Category 2A, often combined with demonstrated adoption across oncology practices.
This has an important implication for communications strategy: guidelines inclusion is a lagging indicator of success, not a leading one. MRD companies that treat guidelines status as their primary goal risk underinvesting in the earlier-stages of evidence generation and clinical adoption work that will actually get them there.
Strategic buyers want economic penetration, portfolio fit and scale
For a large diagnostics company evaluating an acquisition, the most attractive MRD test is not necessarily the most technologically sophisticated — it is the one with the most entrenched clinical relationships. Ordering habits in hospital systems are extraordinarily sticky once established. A dominant player in a high-volume oncology practice is worth far more than a technically superior test with no installed base. Portfolio fit and international scalability round out the picture. For instance, a kit-based test may be attractive because it circumvents the need to ship blood samples internationally, instead enabling local labs to run testing on-site. Buyers may prioritize acquisition of a kit-based MRD test to unlock international self-pay markets in Asia and Pacific regions.
If Technology is an Engine; Translation is the Fuel
What stakeholders care (and don’t care) about can be genuinely counterintuitive from the perspective of an MRD developer. The technology breakthroughs that drive scientific excitement are often precisely the things that stakeholder audiences tune out. Connecting with those audiences doesn’t mean dismissing the significance of a novel approach to MRD testing; it does mean tracing the chain of consequence from a technological innovation to individual impact, and making that chain visible to each audience. That translation work is what HDMZ does. It is a privilege to work at the intersections of science and impact and watch both evolve over time. After a decade in this sector, we have learned that the companies who create the future fastest, are those who invest in connecting with their audiences as rigorously as they invest in their science.
