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Grail Galleri test: FDA premarket approval process

The FDA Molecular and Clinical Genetics Devices Panel recommended approval of the Galleri multi-cancer test for adults aged 50 and older on Sept. 23, 2026. The FDA is now reviewing the final Premarket Approval application to reach a final regulatory decision.

The story so far

written Sep 25

What is happening

The FDA Molecular and Clinical Genetics Devices Panel recommended approval of the Galleri multi-cancer early detection test for adults aged 50 and older on Sept. 23, 2026 [1][5]. The 10-member committee voted 7-2, with one abstention, that the benefits of the blood test outweigh its risks [1][3]. While the panel voted 10-0 in favor of the test's safety, the vote on its effectiveness was 6-4 [1][5].

Panelists reviewed data from the PATHFINDER 2 study, which showed 69.8% sensitivity across 12 high-mortality cancers [5][6]. The committee also evaluated the NHS-Galleri trial, which reported a specificity between 99.7% and 99.9% but did not show a reduction in stage III or IV cancer incidence after three years [5][6]. GRAIL submitted its final Premarket Approval (PMA) application on Jan. 29, 2026 [2][12].

What to watch

The FDA is now reviewing the final PMA application for Galleri [12]. Although the agency is not required to follow the recommendations of its advisory committees, it typically does so [12]. A final regulatory decision is pending [12]. If approved, the test would become commercially available for ordering by U.S. health-care providers.

Read the full brief · how we got here

How we got here

GRAIL submitted its formal application for regulatory approval in early 2026 [2][14]. Before the Sept. 23 meeting, FDA staff reviewers released documents stating they had no major concerns regarding the multi-cancer test [11]. The test is designed to detect a signal shared by more than 50 types of cancer through a single blood draw [1][13].

References · 9
  1. [1]grail.com — FDA Advisory Committee Votes In Favor of Approval of GRAIL's Galleri
  2. [2]grail.com — GRAIL Submits FDA Premarket Approval Application for the Galleri
  3. [3]statnews.com — FDA expert panel endorses Grail's Galleri multi-cancer blood test - STAT
  4. [5]onclive.com — FDA MCGP Panel Vote Backs Galleri Multi-Cancer Early Detection Test
  5. [6]screenmygene.com — FDA's Galleri Panel Vote: What It Means for Genetic Labs
  6. [11]reuters.com — Grail rallies as FDA staff flags no major concerns for multi-cancer ...
  7. [12]fiercebiotech.com — Grail survives adcomm vote as it awaits FDA decision
  8. [13]prnewswire.com — FDA Advisory Committee Votes In Favor of Approval of GRAIL's Galleri ...
  9. [14]prnewswire.com — GRAIL Submits FDA Premarket Approval Application for the Galleri® Multi ...

What would close this

0 of 3 met
The FDA’s Circulatory System Devices advisory committee issues its vote on Galleri.open
The FDA publishes a final pre‑market approval (PMA) decision for Galleri.open
Galleri becomes commercially available for ordering by U.S. health‑care providers.open
If none of these happen, this page closes automatically on .

Timeline

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When we started following: FDA advisory panel backs Grail Galleri approval in 7-2 benefit-risk vote

The FDA Molecular and Clinical Genetics Devices Panel voted Sept. 23 to recommend approval of GRAIL’s Galleri multi-cancer early detection (MCED) test for adults aged 50 and older [1][5]. The 10-member committee voted 7-2, with one abstention, that the test's benefits outweigh its risks [1][3]. While the panel voted unanimously (10-0) in support of Galleri’s safety, the vote on its effectiveness was narrower at 6-4 [1][5].

Panelists reviewed data from the PATHFINDER 2 study, which showed a 69.8% sensitivity across 12 high-mortality cancers, and the NHS-Galleri trial, which reported high specificity of 99.7%–99.9% but failed to reduce stage III/IV cancer incidence after three years [5][6]. The FDA, which is not required to follow advisory recommendations, is now reviewing the final Premarket Approval (PMA) application submitted by GRAIL on Jan. 29, 2026 [2][3][12]. A final regulatory decision is pending [12].