{"entity":{"id":"orimiracle-s","kind":"drug","name":"OriMIRACLE S","aka":["OriMIRACLE","Minimal Residual Circulating Nucleic Acid Longitudinal Detection in Solid Tumor"],"tldr":"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.","status":"emerging","asOf":"2026-11-04","links":[{"label":"Qi et al., OriMIRACLE S in gastrointestinal cancer (Cancer Medicine 2023)","url":"https://doi.org/10.1002/cam4.6286"},{"label":"Fu et al., tumour-informed ctDNA in osteosarcoma (eClinicalMedicine 2024)","url":"https://doi.org/10.1016/j.eclinm.2024.102697"}],"tags":["test","mrd"],"related":["signatera"],"cancers":["gastric","colorectal","osteosarcoma"],"sections":[],"technologies":["mrd-testing","liquid-biopsy"],"targets":[],"drugs":[],"companies":["origimed"],"institutions":[],"pathways":[],"terms":["mrd","ctdna","tumour-informed-assay"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-qi-orimiracle-gastrointestinal-cancer-med-2023","paper-fu-osteosarcoma-ctdna-eclinicalmedicine-2024"],"journals":[],"dependsOn":[],"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."],"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.","approvals":[],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/orimiracle-s/","neighbours":{"drug":[{"id":"signatera","kind":"drug","name":"Signatera","route":"/drugs/signatera/"}],"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"osteosarcoma","kind":"cancer","name":"Osteosarcoma","route":"/cancers/osteosarcoma/"}],"technology":[{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"mrd-testing","kind":"technology","name":"MRD / molecular residual disease testing","route":"/technologies/mrd-testing/"}],"company":[{"id":"origimed","kind":"company","name":"OrigiMed","route":"/companies/origimed/"}],"term":[{"id":"ctdna","kind":"term","name":"Circulating tumour DNA (ctDNA)","route":"/terms/ctdna/"},{"id":"mrd","kind":"term","name":"Minimal / molecular residual disease (MRD)","route":"/terms/mrd/"},{"id":"tumour-informed-assay","kind":"term","name":"Tumour-informed versus tumour-naive ctDNA assays","route":"/terms/tumour-informed-assay/"}],"paper":[{"id":"paper-qi-orimiracle-gastrointestinal-cancer-med-2023","kind":"paper","name":"Monitoring of gastrointestinal carcinoma via molecular residual disease with circulating tumor DNA using a tumor-informed assay","route":"/key-papers/paper-qi-orimiracle-gastrointestinal-cancer-med-2023/"},{"id":"paper-fu-osteosarcoma-ctdna-eclinicalmedicine-2024","kind":"paper","name":"Tumor-informed deep sequencing of ctDNA detects minimal residual disease and predicts relapse in osteosarcoma","route":"/key-papers/paper-fu-osteosarcoma-ctdna-eclinicalmedicine-2024/"}]}}