I think that one of the directions that’s relatively low-hanging fruit is, you know, in the context of our therapeutic clinical trials for glioblastoma and other types of brain cancer, we should be integrating cerebrospinal fluid collection more regularly because that would give us an opportunity to actually start to have much larger banks of samples and be able to test some assays in the setting of a therapeutic trial...
I think that one of the directions that’s relatively low-hanging fruit is, you know, in the context of our therapeutic clinical trials for glioblastoma and other types of brain cancer, we should be integrating cerebrospinal fluid collection more regularly because that would give us an opportunity to actually start to have much larger banks of samples and be able to test some assays in the setting of a therapeutic trial. And you can imagine that’s an atmosphere that’s ripe for biomarker development. It will start to shed additional light on whether this can actually be useful or not for guiding patient care. So that’s an easy thing to do is to just build some cerebrospinal fluid sample collection into our therapeutic trials. I think the other area that is important is we need more prospective, systematically designed studies to really, we would call this a matrix study, which means you want to compare multiple different tissues. So maybe at the same exact point in time for a patient with glioblastoma, you would collect tumor tissue, blood, and cerebrospinal fluid all at the same time. And you would do that two or three times during the course of their disease. And at each one of those time points, you could truly get a sense of, you know, how, what is the concordance between these three compartments in terms of picking up mutations? You would get good numbers in terms of what is the sensitivity and specificity of both blood and cerebrospinal fluid compared to tissue. And we have studies that have done this to varying degrees, but none that have really been a decent sample size with very systematic collection of all of these pre-analytical variables that we talked about. So we’re working on designing such studies, but that is what I think we really need to be able to start to have discussions about developing assays that could eventually be FDA approved and things like that.
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