{"entity":{"id":"idea-bio2-mrd-clinic-service","kind":"idea","name":"A dedicated clinic for people whose blood test says the cancer is back","aka":[],"tldr":"A positive leftover-cancer blood test leaves patients frightened and their doctors unsure what to do. A specialist clinic could give them a plan and a trial.","summary":"The molecular relapse population is growing fast and falls between services: no visible disease, no standard therapy, high anxiety and low trial awareness. A named clinic (confirmatory retesting, sensitive imaging, psychological support, trial screening and structured follow-up) is a service-design intervention that could be evaluated like any other pathway.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Dormant cells and minimal residual disease): Tie et al., ctDNA analysis guiding adjuvant therapy in stage II colon cancer (NEJM 2022)","url":"https://doi.org/10.1056/NEJMoa2200075"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":["mrd-testing","ai-trial-matching"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["mrd"],"trials":[],"people":[],"bottlenecks":["b-dormancy-mrd","b-care-fragmentation","b-patient-voice"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A dedicated molecular relapse clinic increases trial enrolment among ctDNA-positive patients threefold and reduces anxiety scores compared with usual follow-up, with no increase in cost per patient once inappropriate imaging is avoided.","rationale":"Analogous focused services (rapid diagnostic centres, cancer of unknown primary clinics, cardio-oncology) improved both pathway metrics and enrolment. The bottleneck for MRD trials is not eligibility but the absence of anyone whose job it is to act on the result.","test":"Two-centre service pilot with pre-specified metrics: time from positive result to plan, trial enrolment rate, imaging use, patient-reported anxiety at three months.","maturity":"speculative","actor":"clinic","cost":"small","horizonYears":3},"route":"/ideas/idea-bio2-mrd-clinic-service/","neighbours":{"technology":[{"id":"ai-trial-matching","kind":"technology","name":"AI trial matching & clinical decision support","route":"/technologies/ai-trial-matching/"},{"id":"mrd-testing","kind":"technology","name":"MRD / molecular residual disease testing","route":"/technologies/mrd-testing/"}],"term":[{"id":"mrd","kind":"term","name":"Minimal / molecular residual disease (MRD)","route":"/terms/mrd/"}],"bottleneck":[{"id":"b-dormancy-mrd","kind":"bottleneck","name":"Dormant cells and minimal residual disease","route":"/bottlenecks/b-dormancy-mrd/"},{"id":"b-care-fragmentation","kind":"bottleneck","name":"Fragmented care and guideline gaps","route":"/bottlenecks/b-care-fragmentation/"},{"id":"b-patient-voice","kind":"bottleneck","name":"Patients lack understanding, navigation and agency","route":"/bottlenecks/b-patient-voice/"}]}}