# Bank yearly blood from cancer survivors so future tests can be validated

Source: https://onco.cc/ideas/idea-bio2-survivor-plasma-biobank/  
OnCo record `idea-bio2-survivor-plasma-biobank` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

To prove a leftover-cancer test works you need blood taken years before relapse. Collecting and freezing yearly samples now makes every future test testable.

## Summary

Every new MRD or early detection assay needs pre-diagnostic or pre-relapse serial specimens, which take years to accumulate and cannot be created retrospectively. A prospective survivor cohort of 50,000 people banking annual plasma, with registry-linked outcomes and open access rules, would become the shared validation substrate for the whole field.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: A serial survivor plasma bank with linked outcomes shortens the validation cycle for a new MRD assay from five years to under one, and is used by at least ten independent developers within five years of opening.
- Rationale: The UK Biobank and PLCO-style cohorts demonstrate that pre-event specimen collections become disproportionately valuable over time and are impossible to replicate quickly. Survivors are highly motivated donors and are already in follow-up pathways.
- Proposed test: Pilot in 2,000 survivors at high recurrence risk with annual draws for three years; measure retention, cost per sample-year, and number of external validation studies enabled.
- Maturity: speculative
- Actor: data

## Sources

- Bottleneck evidence (Dormant cells and minimal residual disease): Tie et al., ctDNA analysis guiding adjuvant therapy in stage II colon cancer (NEJM 2022): https://doi.org/10.1056/NEJMoa2200075

## Connected records

- collections: [cBioPortal for Cancer Genomics](https://onco.cc/collections/cbioportal/), [SEER (Surveillance, Epidemiology, and End Results)](https://onco.cc/collections/seer/)
- technologies: [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/), [MRD / molecular residual disease testing](https://onco.cc/technologies/mrd-testing/), [Multi-cancer early detection (MCED)](https://onco.cc/technologies/mced/)
- terms: [Circulating tumour DNA (ctDNA)](https://onco.cc/terms/ctdna/), [Minimal / molecular residual disease (MRD)](https://onco.cc/terms/mrd/)
- bottlenecks: [Data silos](https://onco.cc/bottlenecks/b-data-silos/), [Dormant cells and minimal residual disease](https://onco.cc/bottlenecks/b-dormancy-mrd/), [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/)

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