Core Viewpoint - Haystack Oncology, a subsidiary of Quest Diagnostics, has initiated a research collaboration with Rutgers Cancer Institute to evaluate the Haystack MRD test for optimizing postoperative therapy in patients with stage II/III non-small cell lung cancer (NSCLC) [1][2]. Group 1: Research Collaboration and Study Details - The collaboration aims to assess the use of the Haystack MRD test, a highly sensitive circulating tumor DNA (ctDNA) test, to guide postoperative therapy decisions [1]. - The MRD-PORT Trial (NCT06979661) is a prospective phase II study that will determine if the presence of residual tumor DNA after surgery can inform the use of radiation and systemic therapies [1][2]. - Patients testing positive for ctDNA post-surgery will be considered for adjuvant radiation and systemic therapies based on tumor biology and clinical context [2]. Group 2: Importance of ctDNA Testing - ctDNA MRD tests are increasingly recognized for their potential to identify residual or recurring cancer in patients with solid tumors [3]. - A study published in NEJM in April 2025 indicated that ctDNA testing using Haystack MRD identified clinical complete response at a median of 1.4 months, significantly faster than imaging tests which took over 6 months [3]. - A survey revealed that 96% of oncologists believe MRD testing can detect cancer recurrence earlier than current methods [3]. Group 3: Context of Lung Cancer - Lung cancer remains the leading cause of cancer-related deaths in the U.S., with high recurrence rates in stage II and III NSCLC patients [4]. - Studies indicate that patients who test positive for ctDNA after surgery experience significantly worse progression-free survival and overall survival compared to those who test negative [4]. Group 4: Company Background - Haystack Oncology has over 20 years of collaboration in advancing liquid biopsy technologies and developed the Haystack MRD test, which detects ultralow levels of ctDNA [5][6]. - The test is available for commercial use as a lab-developed test (LDT) by Quest Diagnostics and is also utilized in clinical trials as an investigational device [6].

Core Insights - Myriad Genetics announced the publication of a study in The Lancet Oncology, showcasing the effectiveness of its Precise MRD test for patients with oligometastatic clear-cell renal cell carcinoma (ccRCC) [1][4] Study Findings - The study aimed to assess the benefits of ultrasensitive MRD testing in oligometastatic ccRCC patients, revealing that circulating tumor DNA (ctDNA) levels correlate with responses to metastasis-directed radiation therapy (MDT) [2][3] - The Precise MRD test successfully detected ctDNA in patients with low tumor burden, potentially allowing them to delay or avoid systemic treatments, thus reducing side effects and enabling treatment de-escalation [2][3] Key Metrics - In the Phase 2 trial, patients who were ctDNA negative experienced nearly double the median systemic therapy-free survival compared to ctDNA positive patients [3] - 94% of patients tested at baseline had ctDNA levels below 100 ppm, indicating the effectiveness of the ultrasensitive testing [7] - Patients who tested negative for ctDNA maintained MDT for a median of 54 months, while those who tested positive progressed to systemic therapy within a median of 27 months [7] - Overall survival rates for ctDNA negative patients on MDT were 94% at two years and 87% at three years [7] Test Overview - Myriad's Precise MRD Test utilizes whole genome sequencing to monitor numerous tumor-specific variants, providing high sensitivity and quantification of ctDNA in cancer patients [5] - The test can be employed throughout a patient's clinical journey, starting from diagnosis and continuing through treatment [5] Company Background - Myriad Genetics specializes in molecular diagnostic testing and precision medicine, aiming to enhance health and well-being through advanced genetic and genomic testing solutions [8]