A test to tell true oligometastatic disease from hidden widespread spread
Some people have only a few spots of spread and can be cured by treating each one. Others have many spots not yet visible. A test to tell them apart would spare futile treatment and find curable patients.
Ablative treatment of all visible lesions improves survival in selected patients, but selection today is anatomical and therefore crude. Candidate discriminators include ctDNA level and clearance kinetics, microRNA classifiers reported in oligometastatic lung cancer, and clonal diversity across lesions. A locked signature, prospectively validated, would define the biology rather than the lesion count.
- Metastasis is understood least and studied last · Metastasis causes about nine in ten cancer deaths but gets a small fraction of research money and almost no trials of its own.
- 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- IdeaWhen the blood test is positive, hunt for the lesion with sensitive imaging
Shares PSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer, Oligometastatic disease, Metastasis is understood least and studied last, SBRT / SABR (stereotactic radiotherapy).
- IdeaCirculating tumour cell clearance as the phase 2 gate for anti-metastatic drugs
Shares Metastasis is understood least and studied last, Circulating tumour DNA (ctDNA), Biomarkers are not validated or standardised, MRD / molecular residual disease testing.
- IdeaBreak the neutrophil DNA nets that catch tumour cells after surgery
Shares Metastasis is understood least and studied last, Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing, Liquid biopsy (ctDNA).
- PersonMaximilian Diehn
Shares SBRT / SABR (stereotactic radiotherapy), MRD / molecular residual disease testing, Liquid biopsy (ctDNA), Non-small-cell lung cancer.
- PersonAsh A. Alizadeh
Shares Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing, Liquid biopsy (ctDNA), Non-small-cell lung cancer.
- IdeaA blood test for the pre-metastatic niche
Shares Metastasis is understood least and studied last, Biomarkers are not validated or standardised, Liquid biopsy (ctDNA), Colorectal cancer.
- IdeaTake the blood test, and give the drug, at the right time of day
Shares Circulating tumour DNA (ctDNA), Biomarkers are not validated or standardised, MRD / molecular residual disease testing, Liquid biopsy (ctDNA).
- IdeaUse tumour DNA in blood to decide when to pause treatment in metastatic cancer
Shares Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing, Liquid biopsy (ctDNA), Colorectal cancer.