OnCo
ideasIdea

A global rapid tissue donation network for metastatic disease

Almost all cancer deaths are caused by spread, yet very little spread tissue is ever studied. A network collecting donated tissue within hours of death would change that.

Rapid autopsy programmes at a handful of centres have produced disproportionate insight into metastatic evolution and treatment resistance, but they are small, precariously funded and not interoperable. A funded 20-site network with a shared protocol, single consent framework, common data commons and open sample access would industrialise the most information-dense sample type in oncology.

Hypothesis
A shared-protocol network producing 500 multi-site metastatic donations per year yields at least ten validated metastasis-specific dependencies within five years that are absent from primary-tumour datasets.
Rationale
Large-scale primary tumour atlases transformed cancer biology because scale plus openness beat individual excellence. Metastasis has never had an equivalent: existing metastatic sequencing is mostly single-site biopsy material and lacks the paired multi-organ sampling that organotropism and resistance questions require.
What would test it
Fund a three-site pilot to demonstrate short warm-ischaemia protocols, harmonised consent and open data release; measure donations per year, organs per donor and external data requests served.
Maturity
early clinical
Who has to act
philanthropy
Cost to try
Large (over $50M)
Years to first evidence
5
Bottlenecks it attacks

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