{"id":485551,"date":"2024-01-14T02:15:03","date_gmt":"2024-01-14T07:15:03","guid":{"rendered":"https:\/\/platohealth.ai\/predicting-a-patients-future-with-a-crystal-ball-comprised-of-cell-free-dna\/"},"modified":"2024-01-14T02:17:47","modified_gmt":"2024-01-14T07:17:47","slug":"predicting-a-patients-future-with-a-crystal-ball-comprised-of-cell-free-dna","status":"publish","type":"post","link":"https:\/\/platohealth.ai\/predicting-a-patients-future-with-a-crystal-ball-comprised-of-cell-free-dna\/","title":{"rendered":"Predicting a Patient\u2019s Future with a Crystal Ball Comprised of Cell-free DNA","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"

Chapter 1 of a 3-chapter Hitchhiker\u2019s guide to cell-free DNA for travelers of all backgrounds and expertise.<\/em><\/strong><\/p>\n

Even though I\u2019ve been a hematologist\/oncologist for over a decade, I\u2019m horrendous at dealing with death. It still shatters me every time I have to tell a patient they\u2019re going to die of their cancer. It\u2019s supposed to. If it didn\u2019t, I need to find another job.<\/p>\n

There have been clinic days where I\u2019ve seen 30 patients, 17 of which had theoretically incurable cancers. Accordingly, I\u2019m on record as saying nobody would be happier than me if my skill set was no longer needed by society.<\/p>\n

It\u2019s often forgotten that NO TWO CANCER PATIENTS ARE THE SAME. They have different tumor types with different histology, molecular profiles, stages, comorbidities, etc. Accordingly, in a world so heterogeneous, there are next to no generalities in cancer. However, there is a singular universality, \u201cthe earlier the better\u201d. The sooner I know about a patient\u2019s fever, infectious symptoms, etc., the more likely they will do well. The earlier we identify a patient\u2019s cancer the more likely they can be cured.<\/p>\n

In this editorial series we\u2019ve moved at breakneck speed as we talked about the long- and short-term approach to cancer care, and how to assess the claims of people in healthtech, genomics, pharmaceuticals, science, etc. [1, 2, 3]. Today we begin to put the entire cell-free DNA cancer screening industry under the microscope. We will assess the grandiose claims of numerous companies that they are the solution and will enable us to get one step closer to putting me out of work. In so doing, we will draw on the lessons conveyed in the prior \u201cDrowning in Data<\/a>\u201d, \u201cQuarterbacking a Patient\u2019s Cancer Care<\/a>\u201d, and \u201cPlaying Chess Against Cancer<\/a>\u201d entries in this editorial series, as we take a breathtaking tour of the cell-free DNA world with you as CEO.<\/p>\n

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Image credit: Adrienn Harto<\/strong><\/h6>\n

It Begins…<\/h3>\n

It\u2019s well established that cell-free DNA (cfDNA) holds significant promise in assessing mutations in the fetus, identifying and surveilling cancer, predicting a patient\u2019s response to treatments, identifying early signs of solid organ transplant rejection, etc. Yet, this is just the tip of the iceberg as cfDNA will pervade every facet of the medical world. Accordingly, it\u2019s imperative everyone involved in healthcare, including healthtech, pharmaceutical, biotechnology, and clinic employees, have some familiarity with cfDNA.<\/p>\n

A discussion of all potential medical applications of cfDNA would be endless. An exhaustive writing of the putative utility of cfDNA would be several volumes long. Accordingly, we will primarily focus on the use of cfDNA in hematology and medical oncology, largely because it\u2019s my areas of expertise.<\/p>\n

Our tour of cfDNA in blood and cancer diseases will require no previous understanding of molecular biology, and is geared towards everyone. For the reader who has no medical background, we begin our discussion reviewing the basics of DNA, transcription, chromatin, etc., en route to explaining how cfDNA tests are applied in cancer. For the cfDNA specialists, I will ultimately provide a list of NEARLY EVERY SINGLE TUMOR TYPE, and where I personally feel the greatest utility of cfDNA could be. I will detail potential clinical trials in this regard. For the investor and new entrants to the cfDNA space, I will provide a comparative analysis of companies in the cfDNA cancer market, and perceived strategic control points in the field. Indeed, I recently advised two cfDNA start-ups in this regard; I will not be revealing any of their secrets.<\/p>\n

Ultimately, our tour of cfDNA will be three chapters long, this being the first:<\/p>\n