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"How You Can Use AI to Answer Your Cancer Questions"

October 22, 2025. Cancer Patient Lab Session Session 167
Full transcript: docs.google.com/document/d/1VR8rORAhKOGXWp41AMlaCmT2qFUBTpaCoOffN6rlxDo/edit?usp=sharing
Join the discussion: community.cancerpatientlab.org

“Molecular diagnostics is not going anywhere. It's going to get more and more sophisticated, with newer versions of all these assays and tests. There's going to be a lot of consolidation of platforms. It's really an exciting time. Personally, I feel very privileged that I've been able to live through a lot of this over the last few decades. It's just great to see it getting into patients’ hands, providers being able to offer this type of really sophisticated methodology of tests to their patients, as more tools in the tool belt.

“Information is generally power. People have been spending much more time taking ownership of their own health. It's exploded over the past few decades. People have pretty much every question they want answered at their fingertips now, especially with AI. We're entering into a whole different field of informed patients who can start thinking about these types of tests, and are they getting the right treatment.

“The field is absolutely exploding. Over a million commercial tests have now been done. Depending on what you look at, 40-80% of oncologists have used this type of testing (ctDNA MRD) in their practice at this point. People are using it in ways that they believe benefit their patients and as another tool to help understand what's going on with the patient's particular cancer situation. It's clearly taking off.” – Thomas Slavin, MD, MBA, FACMGG, DABMD

Meeting Summary
More people are alive today post-cancer treatment than ever before, thanks to advances in diagnostics and therapies. Yet that also means more people are living with the specter of recurrence. This can be very frightening for cancer survivors, who may always feel that they’re “looking over their shoulder”. This is why “minimal residual disease”, or MRD, testing is so exciting. After cancer treatment, very small amounts of disease may remain in your body, which could be difficult to pick up by traditional testing. MRD tests are a new class of highly sensitive cancer tests that are capable of picking up on these tiny fragments. Studies show that using it as part of the treatment regimen may help tailor cancer treatment. (We focus here on MRD testing for solid tumors, like colon or breast cancer, not MRD testing for blood cancers, like leukemia.)

Thomas P. Slavin Jr., MD, MBA, FACMGG, DABMD, and Chief Clinical Officer of Molecular Oncology and Medical Director of Haystack Oncology (part of Quest Diagnostics), makers of the Haystack MRD Blood test, is uniquely qualified to lead a discussion on monitoring cancer (MRD). He is a physician-scientist and biotech executive, triple-board-certified in clinical genetics, molecular diagnostics and pediatrics. He previously held the positions of Chief Medical Officer at Myriad Genetics and Chief Scientific Officer at HALO Precision Diagnostics. He was a former assistant professor in the departments of Medical Oncology and Population Sciences at City of Hope National Medical Center. Dr. Slavin graduated medical school with Alpha-Omega-Alpha-honors from the University of South Florida. He is an active member of the American Association of Cancer Research, the American Society of Clinical Oncology (ASCO), the Collaborative Group of the Americas on Inherited Colorectal Cancer, and is a fellow of the American College of Medical Genetics and Genomics. He has served on National Comprehensive Cancer Network (NCCN) committees for both the genetics of and screening for colorectal cancer.

Discussion topics:
What is Minimal Residual Disease (“MRD”) testing?

Why should you consider getting an MRD test? What will you miss if you don't get one?

Cancers are good candidates for an MRD test

Besides the general characteristics cited above, these specific cancers (tissues of origin) have been shown to benefit from MRD tests:

Challenges you may face in accessing an MRD test

Accessing a tumor-informed MRD test

Engaging your medical team about getting an MRD test

Learn more:
● Contact Dr. Slavin at t.slavin at haystackoncology.com
● Read recent publications from medical journals like Nature Medicine and New England Journal of Medicine
● Explore resources from American Society of Clinical Oncology
● Check the websites like Quest Diagnostics’ Haystack Oncology

The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action. You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health.

"How a Blood Test - MRD - Can Monitor Your Cancer after Treatment" - Thomas Slavin MD

October 29, 2025. Cancer Patient Lab Session 167
Full transcript: docs.google.com/document/d/18hCuwbWHnnDm6yh0o6-bUa486Sk6bPcV6THp_TrsIF0/edit?usp=sharing
Join the discussion: community.cancerpatientlab.org

“Cancers are complex diseases, and the risk cannot be captured in a single gene mutation, because there is a very complex metabolic cascade. So we need to use this polygenic approach to capture the entire polygenicity, the entire complexity of this mechanism.” – Giordano Botta, PhD

“The work that we have been doing during these years is to combine multiple data sets and develop multiple new methods, and now we can identify individuals with the equivalent risk of those who are already treated or are already under certain screening. It's not a ‘nice to have’. For example, someone who got a 23andMe polygenic risk score was ‘nice to have’ because the magnitude of increasing risk was not actionable from a clinical standpoint. Instead, all our polygenic risk scores are actionable because if someone is detected with a high risk, there is a clear management path to reduce the risk or detect the disease earlier.” – Giordano Botta, PhD

Meeting Summary

Traditional cancer screening often falls short. For breast cancer, current strategies rely on clinical risk factors, age, and a limited set of "monogenic mutations" (changes in a single gene that can lead to a genetic disorder, such as BRCA), leaving many women at risk undetected. For prostate cancer, the standard blood test for screening or monitoring the protein produced by the prostate gland (the “PSA”, Prostate-Specific Antigen), often fails to stratify risk correctly, leading to both over-diagnosis and missed problems.

“Polygenic risk scores”, derived from saliva or blood samples, aggregate the effects of hundreds of thousands of genetic variants, providing a far more comprehensive and accurate picture of inherited cancer risk. With polygenic risk scores, you can:

● Identify the ~20% of women who have a risk equivalent to monogenic mutation carriers but are overlooked by current guidelines.
● Show that even for women with BRCA1/2, CHEK2, or PALB2 mutations, you can dramatically alter lifetime risk, guiding earlier and more tailored screening—sometimes up to 20 years earlier than standard recommendations.
● Improve prostate cancer detection by identifying men at high genetic risk who are missed by the standard of care, helping to overcome the limitations of PSA testing and optimize screening strategies.
● Ensure equity in precision medicine through multi-ancestry PRS, so individuals from all backgrounds benefit equally.

Giordano Botta, PhD, is uniquely qualified to lead a discussion on polygenic risk scores. He is a molecular biologist with a PhD in Public Health. He gained experience doing research alongside leading genomics experts at the University of Oxford and published in Nature before founding Allelica, where he pioneered the development and clinical implementation of multi-ancestry polygenic risk scores to prevent common diseases. Under his leadership, Allelica has published in top-tier journals including Circulation and Nature Communications, filed four patent applications, and supports leading physicians across major healthcare systems. Allelica’s technology is being used to reduce morbidity and mortality from the leading causes of death worldwide through earlier and more precise genomic risk stratification.

Discussion topics include:

How a polygenic risk score can do a better job of predicting your disease risk.

How to be sure that polygenic risk scores are valid

Some challenges you may face in accessing a polygenic risk score

Learn more:

● Conduct research: Read publications about clinical trials and research studies about polygenic risk scores; check out information from major biobanks like UK Biobank, the All of Us Research Program; and attend conferences or find online courses and webinars focused on genomics, precision medicine, and cancer prevention.
● Talk to experts: Consult with genetic counselors and physicians specializing in precision medicine who are adopting polygenic risk score technologies. Follow up with Giordano Botta at giordano at allelica.com and explore the Allelica website: www.allelica.com

The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action. You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health.

How Polygenic Risk Scores Can Improve Cancer Prevention - Giordano Botta PhD

Roger Royse - FDA Advisory Committe