{"entity":{"id":"idea-bio1-rapid-autopsy-network","kind":"idea","name":"A national rapid research autopsy network for end-stage cancer","aka":[],"tldr":"When patients who agreed in advance die of cancer, sampling every tumour within hours reveals how the disease evolved and escaped every drug. Few hospitals can do this today.","summary":"Programmes such as PEACE (UK) and CASCADE (Australia) recruit patients in life for post-mortem multi-site sampling within six hours. The proposal is to fund a standing network with 24-hour on-call pathology, consent embedded in oncology clinics, and a common sample and data model, so that terminal clonal architecture becomes a routine, shareable dataset rather than a rarity.","asOf":"2026-09-08","links":[{"label":"PEACE study (NCT03004755)","url":"https://clinicaltrials.gov/study/NCT03004755"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":["wes-wgs","single-cell-spatial"],"targets":[],"drugs":[],"companies":[],"institutions":["francis-crick","peter-mac","cruk"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-tumor-heterogeneity","b-metastasis-biology"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A network processing 500 rapid autopsies a year yields, within five years, a catalogue of metastatic clonal architectures and resistance mechanisms that identifies at least ten recurrent, druggable terminal dependencies not visible in diagnostic biopsies.","rationale":"Terminal disease is the disease that kills; it is almost never sequenced. Rapid autopsy cohorts have already revealed polyclonal seeding, metastasis-to-metastasis spread and convergent resistance evolution.","test":"Fund three regional hubs with a shared protocol for two years; measure consent rate, time-to-sampling, sample quality, and the number of novel resistance mechanisms per 100 cases versus the published rate from progression biopsies.","maturity":"early-clinical","actor":"philanthropy","cost":"medium","horizonYears":4},"route":"/ideas/idea-bio1-rapid-autopsy-network/","neighbours":{"technology":[{"id":"single-cell-spatial","kind":"technology","name":"Single-cell & spatial profiling","route":"/technologies/single-cell-spatial/"},{"id":"wes-wgs","kind":"technology","name":"Whole-exome & whole-genome sequencing","route":"/technologies/wes-wgs/"}],"institution":[{"id":"cruk","kind":"institution","name":"Cancer Research UK","route":"/institutions/cruk/"},{"id":"peter-mac","kind":"institution","name":"Peter MacCallum Cancer Centre","route":"/institutions/peter-mac/"},{"id":"francis-crick","kind":"institution","name":"The Francis Crick Institute","route":"/institutions/francis-crick/"}],"bottleneck":[{"id":"b-metastasis-biology","kind":"bottleneck","name":"Metastasis is understood least and studied last","route":"/bottlenecks/b-metastasis-biology/"},{"id":"b-tumor-heterogeneity","kind":"bottleneck","name":"Tumour heterogeneity and clonal evolution","route":"/bottlenecks/b-tumor-heterogeneity/"}]}}