Reference materials and open proficiency testing for residual disease tests
Different companies' leftover-cancer blood tests disagree, and there is no shared yardstick. Public reference samples would let anyone check which test actually works.
Tumour-informed and tumour-naive ctDNA assays report different sensitivities at different variant allele fractions, and cross-assay comparisons are almost entirely vendor-run. A public reference material programme — synthetic and patient-derived contrived plasma at defined fractions, blinded rounds, published per-assay results — would do for MRD what proficiency schemes did for HER2 immunohistochemistry.
- Dormant cells and minimal residual disease · After a 'successful' treatment, cells can sleep for years then relapse. We can barely detect them and cannot target them.
- Biomarkers are not validated or standardised · Tests that decide who gets a drug are often not validated prospectively and are measured differently in every lab.
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not linked directly; found by shared links- IdeaCertified reference samples to benchmark every tumour-DNA blood test
Shares Natera, Variant allele frequency (VAF), Guardant Health, Minimal / molecular residual disease (MRD).
- TechnologyContinuous and near-continuous ctDNA monitoring
Shares Foresight Diagnostics, Natera, Guardant Health, Minimal / molecular residual disease (MRD).
- IdeaPush residual disease detection a hundredfold deeper with whole-genome methods
Shares Foresight Diagnostics, Variant allele frequency (VAF), Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD).
- IdeaAn annual blinded shoot-out for liquid biopsy tests
Shares Natera, Variant allele frequency (VAF), Guardant Health, Biomarkers are not validated or standardised.
- TechnologyctDNA monitoring in lymphoma (PhasED-seq, clonoSEQ)
Shares Foresight Diagnostics, Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), MRD / molecular residual disease testing.
- IdeaTake the blood test, and give the drug, at the right time of day
Shares Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), Biomarkers are not validated or standardised, MRD / molecular residual disease testing.
- IdeaWatch the immune system's response in the blood three weeks in
Shares Adaptive Biotechnologies, NGS-based MRD (clonoSEQ and molecular MRD), Biomarkers are not validated or standardised, Liquid biopsy (ctDNA).
- Key paperGALAXY: tumour DNA in blood four weeks after bowel cancer surgery predicts relapse tenfold
Shares Variant allele frequency (VAF), Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), Biomarkers are not validated or standardised.