ClearNote Health, a San Diego company developing blood tests to detect cancer before symptoms appear, has closed a $52 million Series D financing round. The company was founded out of the laboratory of Dr. Stephen Quake at Stanford University and is focused on patients at elevated risk for pancreatic and ovarian cancers. Along with the funding, Kevin Keegan, a diagnostics industry veteran with nearly 30 years of experience, has joined as president and chief operating officer.
The numbers behind these two cancer types explain why early detection tools are so needed. Pancreatic cancer has a five-year survival rate of around 40% when caught while still localized, but that figure drops to roughly 3% once the disease has spread. Ovarian cancer shows a similar pattern. Survival rates can exceed 90% with early diagnosis, yet more than 80% of patients are not diagnosed until the cancer has already reached an advanced stage, largely because no practical screening tools have existed for most people at risk. The broader liquid biopsy market, which covers blood-based cancer tests, was valued at approximately $7 billion in 2025 and is forecast to exceed $27 billion by 2035, as demand for noninvasive diagnostics continues to grow.
The Series D was led by founding investor Mattias Westman, described as a global large long-only active manager. Other participants included Sandy Weill, former CEO and chairman of Citigroup; Dr. Stephen Quake, co-founder of ClearNote Health and a Stanford professor; a large Seattle-based family office; and other U.S. and international institutional investors. With this round, the company has now raised more than $185 million in total.
Both pancreatic and ovarian cancers tend to grow without obvious symptoms. By the time most patients experience something noticeable, the cancer has usually progressed. Until recently, clinicians had little to offer patients in terms of early detection outside of imaging, which is not practical for routine screening and often misses early-stage disease.
ClearNote Health's tests are built around a biological signal called 5-hydroxymethylcytosine, or 5hmC. This is a chemical tag found on DNA. The pattern of these tags differs between cancer cells and healthy cells in ways that can be measured from a standard blood draw. The company's platform reads those differences using sequencing technology and machine learning models trained to identify cancer-related signals. No surgery or tissue sample is required.
"I invested early because I believed ClearNote Health was tackling one of the most important challenges in healthcare," said Mattias Westman. "The potential to detect cancer earlier through epigenomic signals in blood is incredibly compelling, and the team has continued to execute with focus, scientific rigor, and a real sense of purpose. The progress they've made so far has only strengthened my belief in what the company can achieve."
The proceeds are allocated across four areas: commercial expansion, clinical studies, product development, and broader access to its test portfolio. On the commercial side, the Avantect Pancreatic Cancer Test recently received approval from the New York State Department of Health. The company also signed several international distribution agreements in 2024, making its tests available in more than 50 countries. The new capital is expected to support further expansion on that front.
ClearNote Health is also developing a multi-cancer detection test, and it has been selected by the U.S. National Cancer Institute for its Vanguard Study, a large evaluation of blood-based multi-cancer screening technologies. Only two blood-based platforms were chosen for the study, making the selection a meaningful independent endorsement as the company pursues wider clinical adoption and insurance reimbursement.
Keegan's appointment as president and COO points toward an operational focus. He previously held senior roles at BD, Illumina, and Hologic. At Illumina, he served as general manager of oncology and oversaw the launch of one of the most widely used tumor profiling tests in clinical practice.
The company was founded in 2016 as Bluestar Genomics, based on research from the Quake laboratory at Stanford. It rebranded as ClearNote Health in late 2022 when it moved into commercial operations. Its headquarters and clinical laboratory are in San Diego, and the lab holds CLIA certification, CAP accreditation, and New York State Department of Health approval.
Its two main products, the Avantect Pancreatic Cancer Test and the Avantect Ovarian Cancer Test, are sold at avantect.com. These are not general screening tools for the wider population. They are designed specifically for people who have already been identified as high-risk, such as those with a family history, a known genetic predisposition, or conditions like new-onset type 2 diabetes, which is associated with higher pancreatic cancer risk.
The company also runs a platform called Virtuoso, which it offers to pharmaceutical companies. Virtuoso measures how cancer cells respond to drugs at a biological level, giving drug developers information that standard tissue biopsies may not capture. This service is a second revenue line separate from the clinical testing business.
"During my career, I have focused on expanding access to genomics-based oncology diagnostic tools," said Kevin Keegan, incoming president and COO. "ClearNote Health has a purpose-built platform that has the potential to fundamentally improve outcomes for patients at elevated risk of cancer by diagnosing disease earlier. I'm excited to join this talented team and to help drive the company's next growth phase."
Total funding now stands at more than $185 million. The $70 million Series C, raised while the company still operated as Bluestar Genomics, was also led by founding investor Mattias Westman.
The Series D investor group includes both institutional and individual participants. Sandy Weill, former CEO and chairman of Citigroup, joined the round alongside Dr. Stephen Quake, who continues to hold roles as co-founder, investor, and active Stanford professor. A Seattle-based family office and several international institutional investors round out the group, which spans the U.S. and global markets.
