OnCo
ideasIdea

Match each blood-detected clone to the lesion it comes from on the scan

Blood tests tell you which tumour sub-populations are growing; scans tell you which lesions are growing. Joining the two would tell you where to biopsy or irradiate.

Tissue-of-origin methylation, lesion-specific private mutations from multi-site biopsies, and lesion volume kinetics from serial imaging could be combined in a joint model that assigns plasma clone fractions to anatomical lesions. This would let clinicians direct local therapy at the lesion carrying the expanding resistant clone without biopsying every site.

Hypothesis
A joint ctDNA-imaging model localises the source lesion of an emerging resistant clone correctly in most cases when validated against multi-site biopsy or autopsy.
Rationale
Lesion-level heterogeneity is the norm in metastatic disease; ctDNA is lesion-agnostic and imaging is genotype-agnostic. The two are rarely modelled together.
What would test it
Retrospective model building on rapid autopsy cases with serial plasma and imaging in life; prospective validation in patients undergoing multi-site biopsy at progression.
Maturity
speculative
Who has to act
data
Cost to try
Small (under $1M)
Years to first evidence
4
Bottlenecks it attacks

Connected

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