GRAILs cfRNA paper
I’ve been slowly collecting and reading through GRAILs papers (for those interested, a link to the spreadsheet is on Discord). There are a number of reasons for this1. But in particular I’m interested in better understanding if GRAIL is really worth $8B, and learning a bit more about the composition of cfDNA/RNA.
The basic GRAIL story so far seems to be, they tried super high depth cfDNA sequencing. It kind of worked for screening, but not well enough. So they tried adding methylation into the mix and it worked pretty well.
Along the way, they seem to have tried a few other things, including looking at cfRNA, and it’s their work on cfRNA that I’m going to look at today.
As far as I can tell this is the only paper from GRAIL using cfRNA and while it was published in 2021 I suspect the data is even older (they’re using HiSeq’s)2.
Firstly, I want to take a look at the overall structure of the project:
Essentially the project proceeded in two phases, in the first which they call the “discovery cohort” they looked at later stage cancers. GRAIL have previously shown solid results on