Exploring Northstar Select: A Liquid Biopsy Built for Clinical Action

Comprehensive genomic profiling (CGP) using liquid biopsy has changed the way oncologists approach care for advanced cancers. But not all liquid CGP are created equal. Many tests offer broad gene coverage but the bigger the panel, the less sensitive the test is and when looking for treatable alterations in blood, sensitivity matters most. Northstar Select was built to address this critical challenge by bringing single-molecule NGS (smNGS) technology to liquid biopsy with a hyper focus on sensitivity, enabling clinicians to uncover more opportunities for treatment with reports built for clear, clinical action.

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Why We Built It

The amount of circulating tumor DNA (ctDNA) found in a blood sample cannot be predicted by clinical variables, and even traditionally high-shedding tumors (e.g. CRC, Breast, SCLC etc.) can have driver mutations found with low concentrations or variant allele frequencies (VAF) in the blood, which can be missed by tests with sub-par limit of detection thresholds. We built Northstar Select to maximize treatment opportunities by pushing the liquid biopsy field forward, and setting a new standard in sensitivity with an LOD 95 of 0.15% VAF, approximately 2-5x lower than first generation liquid biopsies.

Northstar Select was created for these moments— and validated with clinical data. In a recently published head-to-head clinical validation study, Select detected 51%* more actionable alterations than other liquid biopsy tests. These included variants in genes with FDA-approved therapies, such as ESR1 where we found 50% more of these resistance mutations. 

Where some platforms prioritize breadth over precision, Select focuses on what matters most, not missing an opportunity for treatment. 

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‍*When compared to the comparator products in the aggregate. Actual percentages may vary depending on the individual comparator test

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Technology at the Core

Northstar Select is powered by BillionToOne’s proprietary smNGS platform with QCT™ (Quantitative Counting Templates), delivering:

• 95% Limit of detection (LOD 95) as low as 0.15% VAF for SNV/indels
  
• An optimized 84-gene panel focused on guideline recommended SNV / indels, CNA* (amplification and losses), fusions and MSI-H status
  
• Reports that prioritize actionability and are easy to interpret

* CNA = copy number alteration

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How It’s Used in Practice

Northstar Select can be used:

• For all late-stage or advanced solid tumor cancers
• At diagnosis or disease progression
• In parallel with tissue CGP to improve diagnostic yield or improve time-to-treatment (e.g. NSCLC)
• When re-biopsy is not feasible or has already failed

Select complements your existing tools and enhances confidence in cases where uncertainty is highest.

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Summary

Northstar Select is a liquid biopsy built for moments when clinical clarity is most urgent—at diagnosis, at progression, or when tissue is not feasible. With single-molecule sensitivity and a focused 84-gene panel aligned to guideline-driven care, Select offers meaningful results without unnecessary complexity. It detects actionable alterations others may miss, and it does so with a turnaround time typically in 5-8 days. In a landscape where some tests prioritize quantity over precision, Select delivers what matters: clinically useful information, presented clearly, so oncologists can make timely and confident decisions. If you’re navigating difficult cases where speed, sensitivity, and actionability are critical, Northstar Select is designed for you.

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Connect with us to learn how Northstar Select can help optimize  your clinical workflow. ‍

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