
Biotech firm Grail conducting large study for early breast cancer detection - akakievich
https://www.sfchronicle.com/business/article/Biotech-firm-Grail-conducting-large-study-for-13510156.php
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dontreact
Liquid biopsy is an exciting field but to call the current results “promising”
seems like a stretch to me. The entire point of doing screening is catching
early stage cancers. For these cancers, liquid biopsies miss far more than
imaging in every study I’ve seen (even early non peer reviewed results). For
this reason there is as of yet no evidence that drawing a blood sample can be
a first step before imaging for the high risk populations where screening is
done today. You still need to do imaging for those.

However, it seems like an interesting avenue for increasing the size of the
screening population but then false positives become a serious problem within
a low risk population.

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sjg007
This is definitely a get all of the data and see what sticks type of analysis.
There should be some early evidence from a smaller sample set using cluster
analysis that is suggestive that mutations can be classified and are
predictive. Tons of issues to resolve. I would think that some
biostatisticians should be able estimate the false positive rate from a
theoretical basis.

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dontreact
My point is that there have already been a lot of results showing liquid
biopsy misses a lot of the cancers in high risk populations. At this point
theoretical estimates seem inferior as evidence than what we know so far from
actually measuring.

At some point in the future we may understand more about what markers to look
for in the blood and this may change but as of yet there are no "promising"
results. Maybe I'm nitpicking but the concept of liquid biopsy is exciting and
I hope it's something that humanity figures out how to do!

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sjg007
Do you have a reference I could check out? My point was this is looking at
sequencing all of the cell free DNA and seeing post hoc if any of that data is
predictive of some cancer developing. There are a wide number of issues taking
that approach including it not being viable at all. Still it is an interesting
data set. And as you state there are other biomarkers that may be more useful
that still fall under the category of a liquid biopsy.. what we really mean
here is something non-invasive like a blood draw.

I was interested in the FP rate theoretically just cause it would be
interesting to understanding the screening watchful waiting type approach vs
what we have now.

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dontreact
43% of Stage I cancers detected, 33% of breast cancers detected and called
"the best result so far" by this one science blogger (for breast imaging these
numbers are usually around 90):

[https://blogs.sciencemag.org/pipeline/archives/2018/01/22/a-...](https://blogs.sciencemag.org/pipeline/archives/2018/01/22/a-hard-
look-at-liquid-biopsies)

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samuell
Fun fact: Grail (or, Marius at Grail) wrote their own scientific workflow
engine in Go, with a focus on AWS as execution platform:

[https://github.com/grailbio/reflow](https://github.com/grailbio/reflow)

Fo anyone interested, we reviewed it including a comparison to other Go based
wf tools (the number is obviously growing):

[http://gopherdata.io/post/more_go_based_workflow_tools_in_bi...](http://gopherdata.io/post/more_go_based_workflow_tools_in_bioinformatics/)

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annefauvre
This is awesome. Biopsies today are incredibly invasive and painful. Anything
that makes things less painful, safer, and cheaper is great -- means more ppl
can use it and more ppl will get screened.

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yters
Do they also look at life factors to see if there are features that correlate
with breast cancer incidence? E.g. like how smoking correlates with lung
cancer.

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simonsarris
It would seem like from a public health perspective, this is the more
important thing to research.

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bananatron
I read this as Gmail at first.

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JohnJamesRambo
I bet gmail could actually predict breast cancer quite well if it was let
loose on it.

[https://www.breastcancer.org/risk/factors](https://www.breastcancer.org/risk/factors)

Your email knows how much you do of many of those things.

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dogma1138
Maybe 10 years ago today it would be Facebook.

That said I always wondered if HID devices and mobile phones could be used to
detect early symptoms of Parkinson’s and other neural or neuromuscular
syndroms.

