Kill combination arms early using circulating tumour DNA, before waiting for scans
A blood test at six weeks can show whether a treatment is doing anything. Trials should use it to drop failing combinations fast and move patients on.
Molecular response (ctDNA clearance or fall below a threshold at 6 to 9 weeks) correlates with progression-free and overall survival across several tumour types and drug classes. Platform trials could use pre-specified ctDNA futility rules at 20 patients per arm to stop non-performing combinations months earlier than radiological endpoints allow.
- Too many combinations to test · There are thousands of possible drug pairs and sequences. Trials can test a few dozen a year.
- 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.
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not linked directly; found by shared links- IdeaUse a blood test at six weeks to decide whether to keep going
Shares CD8 PET to stop or switch immunotherapy early, RECIST, Circulating tumour DNA (ctDNA), Progression-free survival (PFS).
- IdeaMake clonal clearance, not tumour shrinkage, a trial endpoint
Shares RECIST, Circulating tumour DNA (ctDNA), Progression-free survival (PFS), Trial design, endpoints and cost.
- IdeaUse tumour DNA in blood to decide when to pause treatment in metastatic cancer
Shares Natera, Guardant Health, Circulating tumour DNA (ctDNA), Trial design, endpoints and cost.
- IdeaCertified reference samples to benchmark every tumour-DNA blood test
Shares Natera, Guardant Health, Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA).
- IdeaAn annual blinded shoot-out for liquid biopsy tests
Shares Natera, Guardant Health, Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA).
- TechnologyContinuous and near-continuous ctDNA monitoring
Shares Natera, Guardant Health, Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA).
- IdeaDrop mandatory fresh biopsies where blood or archival tissue would do
Shares Guardant Health, Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA).
- IdeaValidate real-world progression endpoints so pragmatic trials can use them
Shares RECIST, Progression-free survival (PFS), Trial design, endpoints and cost.