Detecting cancer relapse months earlier and at a fraction of the cost
Current cancer monitoring methods are costly and often detect relapse only after tumours have become visible. Tests may cost thousands of dollars per run, making them impractical for frequent use. At A*STAR, researchers studied DNA fragment-length patterns in plasma — a field known as fragmentomics — and discovered they reveal tumour activity even at very low levels. From this research, they developed Fragle, an AI-powered tool that quantifies circulating tumour DNA (ctDNA) rapidly and at a fraction of the cost.
Fragle works with ultra-low-pass whole-genome sequencing or targeted panels already in hospitals, returning results in under a minute. Validated in a study featured in Nature Biomedical Engineering (March 2025), it can measure ctDNA fractions as low as 1%. The National Cancer Centre Singapore is now applying it in an ongoing trial with more than 100 lung cancer patients, monitored every two months to track ctDNA dynamics and detect relapse earlier than standard imaging. By lowering costs and simplifying workflows, Fragle makes ctDNA analysis practical for routine use, enabling earlier intervention and more equitable access to personalised oncology.
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