Summary
The Drive podcast episode features a physician-scientist who specializes in radiation oncology. The physician-scientist talks about their research interests and how they are working on developing a liquid biopsy test for lung cancer. The limitations of traditional imaging methods and protein-based biomarkers are discussed, and the importance of sensitivity and specificity in detecting cancer is emphasized. The history of using biomarkers for cancer detection is also touched upon. The physician-scientist explains the challenges of reproducing results in scientific research and the bias towards positive findings in the publication realm.
The podcast also discusses the challenges of diagnosing cancer recurrence and the search for a better method using liquid biopsies. The speaker explains that imaging tests should only be ordered if they will change patient management and discusses the need for earlier detection of cancer recurrence. The speaker collected blood samples to search for biomarkers and tried protein biomarkers and circulating tumor cells, but found them to be complicated and lacking specificity. The speaker emphasizes the difficulty of reproducing results in scientific research.
The context also discusses the use of cell-free DNA for clinical purposes, specifically in cancer patients. The interest in using cell-free DNA for cancer detection came from the success in detecting DNA from fetuses in pregnant mothers. The speaker explains the methods used in laboratories to quantify the amount of DNA in a sample and the use of next-generation sequencing to identify mutations in the DNA. The context discusses the use of liquid biopsies to detect cancer through the analysis of cell-free DNA and RNA.
The speaker emphasizes the importance of breaking down sensitivity by stage, as including more stage four patients can bias the results. The discussion revolves around the sensitivity and specificity of liquid biopsies for cancer screening. The speaker believes that large randomized trials are necessary to prove cancer-specific survival benefits of liquid biopsies. The context discusses liquid biopsies, which use next-generation sequencing to measure circulating tumor DNA. These tests are designed to identify mutations in patients with metastatic cancer to determine the appropriate treatment.
The podcast also discusses the potential use of liquid biopsies in cancer treatment and screening. The speaker discusses the potential of combining multiple features, such as methylation and mutation, to develop the best screening test for cancer. The speaker hopes to increase the sensitivity of the test to at least 50-75% for early stage one cancer, while keeping the specificity north of 99%. They also mention that companies are constantly working to improve their tests, but it is too early to know how much they will push the bar.
