Genomics Thread #6

Let's talk about liquid biopsies...

1/ A liquid biopsy is usually a blood-based test that can detect cancer.

How?

By detecting either CTC (circulating tumor cells) or ctDNA (circulating tumor DNA). In some studies, ctDNA has been shown to have 100x the concentration as CTC though.
2/ So why is this important?

Well, the standard of care is tissue biopsies. Doctors lop off a piece of the potentially cancerous area (a chunk of your lung for lung cancer for instance) to verify if cancer exists.

However, tissue biopsies are inferior in a few ways...
3/

1. For one, there are more complications. Lung biopsies had a 19% complication rate.

2. They are also expensive, costing nearly $15,000 for each one.

3. They leave a scar and require a surgery

4. It takes a while to get the results

5. Not a lot of tissue can be retrieved
4/ On the other hand, liquid biopsies only require a vial of blood. These genetic tests can profile dozens of genes and determine whether a tumor is malignant.

The main players that already have an approved test are Guardant Health and Foundation Medicine (owned by Roche).
5/ However, many companies are jumping into this space. Because Guardant's LUNAR assay may detect colorectal cancer, Exact Sciences bought Thrive recently for nearly $2.2 billion.

Invitae also bought ArcherDx recently to be competitive.
6/ Guardant Health (GH) has two commercial products, Guardant360 (the world's leading liquid biopsy) and GuardantOMNI for biopharma customers. And two more pipeline products (LUNAR 1 and 2)

Currently, most of the testing is done for NSCLC (non-small cell lung cancer).
7/ Another advantage is that biopharma customers can easily do more testing to see whether their gene therapies are working and if the ctDNA is now less concentrated. That's not really feasible with tissue biopsies.
8/ While Guardant is approved for NSCLC, it is currently trying to use its test for other types of cancer.

To be clear, liquid biopsies won't completely replace tissue biopsies yet. However, there will likely be a "liquid-first paradigm."

If positive, then no need for tissue.
9/ But if negative through the liquid biopsy, there will likely be a tissue biopsy to ensure the diagnosis.

That's not to say liquid biopsies aren't accurate. They are. It's just that very early stage cancer can have very low concentrations of ctDNA.
10/ Besides Guardant, Roche's Foundation Medicine has a diagnostic for prostate cancer or NSCLC patients who might benefit from immunotherapy.

https://t.co/mpOhGNNLtp

I wouldn't be surprised to see A LOT of new developments in this space in the next few years.
End/ Natera is also working on a liquid biopsy as well as Illumina-owned GRAIL.

In other words, there is a lot of competition but the prize is huge.

Liquid biopsies will enable faster drug production through clinical trials and detect cancer much earlier.

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I just finished Eric Adler's The Battle of the Classics, and wanted to say something about Joel Christiansen's review linked below. I am not sure what motivates the review (I speculate a bit below), but it gives a very misleading impression of the book. 1/x


The meat of the criticism is that the history Adler gives is insufficiently critical. Adler describes a few figures who had a great influence on how the modern US university was formed. It's certainly critical: it focuses on the social Darwinism of these figures. 2/x

Other insinuations and suggestions in the review seem wildly off the mark, distorted, or inappropriate-- for example, that the book is clickbaity (it is scholarly) or conservative (hardly) or connected to the events at the Capitol (give me a break). 3/x

The core question: in what sense is classics inherently racist? Classics is old. On Adler's account, it begins in ancient Rome and is revived in the Renaissance. Slavery (Christiansen's primary concern) is also very old. Let's say classics is an education for slaveowners. 4/x

It's worth remembering that literacy itself is elite throughout most of this history. Literacy is, then, also the education of slaveowners. We can honor oral and musical traditions without denying that literacy is, generally, good. 5/x
IMPORTANCE, ADVANTAGES AND CHARACTERISTICS OF BHAGWAT PURAN

It was Ved Vyas who edited the eighteen thousand shlokas of Bhagwat. This book destroys all your sins. It has twelve parts which are like kalpvraksh.

In the first skandh, the importance of Vedvyas


and characters of Pandavas are described by the dialogues between Suutji and Shaunakji. Then there is the story of Parikshit.
Next there is a Brahm Narad dialogue describing the avtaar of Bhagwan. Then the characteristics of Puraan are mentioned.

It also discusses the evolution of universe.(
https://t.co/2aK1AZSC79 )

Next is the portrayal of Vidur and his dialogue with Maitreyji. Then there is a mention of Creation of universe by Brahma and the preachings of Sankhya by Kapil Muni.


In the next section we find the portrayal of Sati, Dhruv, Pruthu, and the story of ancient King, Bahirshi.
In the next section we find the character of King Priyavrat and his sons, different types of loks in this universe, and description of Narak. ( https://t.co/gmDTkLktKS )


In the sixth part we find the portrayal of Ajaamil ( https://t.co/LdVSSNspa2 ), Daksh and the birth of Marudgans( https://t.co/tecNidVckj )

In the seventh section we find the story of Prahlad and the description of Varnashram dharma. This section is based on karma vaasna.