# OriMIRACLE S

Source: https://onco.cc/drugs/orimiracle-s/  
OnCo record `orimiracle-s` (Test). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

OrigiMed's personalised blood test for leftover cancer, which deliberately tracks only mutations shared by every tumour cell.

## Summary

OriMIRACLE S was developed by OrigiMed of Shanghai and described in Cancer Medicine in 2023 (Qi et al.) in 127 patients with gastrointestinal tumours: panels of 21 to 30 clonal variants, positivity defined by three detected sites, residual disease detected before surgery in 18 of 26 patients and after surgery in 24 of 82. A 2024 study of 59 patients with osteosarcoma at Sun Yat-sen University, with OrigiMed co-authors and the same variant selection, found that ctDNA after surgery predicted event-free survival and preceded imaging by an average of 92.6 days in five patients.

## Fields

- Kind: Test
- Status: emerging
- Last checked: 2026-11-04
- Also known as: OriMIRACLE; Minimal Residual Circulating Nucleic Acid Longitudinal Detection in Solid Tumor
- Tags: test; mrd
- Brand: OriMIRACLE S
- Modality: Tumour-informed ctDNA minimal residual disease test (clonal variants, multiplex PCR)
- Mechanism: Whole-exome sequencing of tumour and matched normal DNA; the OriSelector algorithm picks clonal single-nucleotide variants for a patient-specific multiplex PCR panel, and a sample is called positive when three tracked sites are detected.

## Notes

- Stated limit of detection, from the osteosarcoma paper's methods: "The detection limit for variant allele frequency (VAF) is as low as 0.01%", with 25 to 100 ng of DNA from an 8 to 20 mL blood sample (Fu et al., eClinicalMedicine 2024). That is 100 parts per million.
- Because only clonal variants are tracked, by design the test cannot report a subclone.

## Sources

- Qi et al., OriMIRACLE S in gastrointestinal cancer (Cancer Medicine 2023): https://doi.org/10.1002/cam4.6286
- Fu et al., tumour-informed ctDNA in osteosarcoma (eClinicalMedicine 2024): https://doi.org/10.1016/j.eclinm.2024.102697

## Connected records

- drugs: [Signatera](https://onco.cc/drugs/signatera/)
- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/), [Osteosarcoma](https://onco.cc/cancers/osteosarcoma/)
- technologies: [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/), [MRD / molecular residual disease testing](https://onco.cc/technologies/mrd-testing/)
- companies: [OrigiMed](https://onco.cc/companies/origimed/)
- terms: [Circulating tumour DNA (ctDNA)](https://onco.cc/terms/ctdna/), [Minimal / molecular residual disease (MRD)](https://onco.cc/terms/mrd/), [Tumour-informed versus tumour-naive ctDNA assays](https://onco.cc/terms/tumour-informed-assay/)
- key papers: [Monitoring of gastrointestinal carcinoma via molecular residual disease with circulating tumor DNA using a tumor-informed assay](https://onco.cc/key-papers/paper-qi-orimiracle-gastrointestinal-cancer-med-2023/), [Tumor-informed deep sequencing of ctDNA detects minimal residual disease and predicts relapse in osteosarcoma](https://onco.cc/key-papers/paper-fu-osteosarcoma-ctdna-eclinicalmedicine-2024/)

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