Use tumour DNA in blood to decide when to pause treatment in metastatic cancer
If a blood test shows no tumour DNA after months of treatment, a trial could test pausing the drug and restarting only when the DNA reappears, giving patients time off without waiting for scans to show growth.
Randomised trials in metastatic disease where patients with sustained ctDNA clearance on therapy are allocated to continued treatment or a monitored treatment holiday with ctDNA-triggered resumption. Endpoints: time to treatment failure, time on treatment, QoL, OS non-inferiority. Distinct from adjuvant ctDNA-guided escalation (DYNAMIC, IMvigor011), this addresses de-escalation in the palliative setting where lead time over imaging gives a safety margin.
- Trial design, endpoints and cost · A phase 3 trial takes years and hundreds of millions of dollars, and often answers a question that has already moved on.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
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not linked directly; found by shared links- IdeaCertified reference samples to benchmark every tumour-DNA blood test
Shares Natera, Guardant Health, Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
- IdeaA national residual-disease weather service: serial blood tests for every curatively treated patient, pooled
Shares DYNAMIC, IMvigor011, Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
- IdeaKill combination arms early using circulating tumour DNA, before waiting for scans
Shares Natera, Guardant Health, Circulating tumour DNA (ctDNA), Trial design, endpoints and cost.
- TechnologyContinuous and near-continuous ctDNA monitoring
Shares Natera, Guardant Health, Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
- IdeaDrop mandatory fresh biopsies where blood or archival tissue would do
Shares Guardant Health, Circulating tumour DNA (ctDNA), Toxicity and quality of life are undervalued, Liquid biopsy (ctDNA).
- Key paperDYNAMIC: a blood test safely halved chemotherapy use after surgery for stage II colon cancer
Shares DYNAMIC, Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing, Trial design, endpoints and cost.
- IdeaFormally qualify tumour-DNA blood tests as a surrogate endpoint for adjuvant trials
Shares DYNAMIC, IMvigor011, Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
- IdeaAn annual blinded shoot-out for liquid biopsy tests
Shares Natera, Guardant Health, Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA).