Skip to navigationSkip to main contentSkip to right columnADVERTISEMENTLee Samaha, The Motley FoolMon, June 22, 2026 at 12:25 AM GMT+2 5 min readMulti-cancer early detection (MCED) test company Grail (NASDAQ: GRAL) is one of the most fascinating mid-cap healthcare stocks on the market. Usually, when a company misses a primary endpoint in a landmark trial, it's time to fold the hand and focus on the next one. The reality is that many investors did just that, and the stock is down more than 30% in 2026 as I write. Still, there's a case building for its MCED test to receive approval from the Food and Drug Administration (FDA) and coverage from medical insurers. Here's what you need to know before investing in the stock.Grail's Galleri testThe Galleri MCED test is intended to detect more than 50 cancers at an early stage, and in doing so, improve patient outcomes while significantly reducing treatment costs -- late-stage cancers (III and IV) are far more costly and invasive to treat. To demonstrate Galleri's efficacy, Grail conducted two high-profile studies: a 35,900-person study in North America (PATHFINDER 2) and a three-year, 142,000-person trial in England (NHS-Galleri) with England's National Health Service (NHS).Missed Nvidia in 2009? This Rare Signal Is Flashing Again. In 2009, a "Double Down" signal flashed for a little-known chipmaker called Nvidia. For the first time in years, that same "Total Conviction" signal is flashing for a company 1/100th the size of Nvidia. Continue »Unfortunately, Grail had bad news for investors in February when it released top-line results from the NHS and outlined that it had missed its primary endpoint of demonstrating "statistically significant Stage III-IV reduction" in its trial. The idea is that, by detecting cancer at early stages (I-II), the tested group should see a reduction in Stage III-IV cancers compared to the control group.The stock was, understandably, sold off heavily after the news broke, but has recovered about 18.4% as some investors are pricing in the possibility that Galleri could still receive FDA approval and coverage. Management sought to strengthen that case with a much-anticipated presentation at the American Society of Clinical Oncology (ASCO) annual meeting, only to receive a mixed reception from the market afterward.Where next for Grail and GalleriDespite missing a primary endpoint, management continues its iterative process with the FDA to secure approval for Galleri and provide more evidence of its suitability for medical coverage. There are potentially three factors that could favor the company achieving both.Image source: Getty Images.First, Grail believes 12-month follow-up data from the NHS trial will prove out the trial because "there are people in the control arm who have cancer that isn't being found because it hasn't presented clinically. So after another 12 months go by, more of those cancers will show up," according to CFO Aaron Freidin at a recent Goldman Sachs conference.Terms and Privacy PolicyEU DSA contactPrivacy & Cookie SettingsMore Info