The Problem That Drives MIRAGE
A patient finishes surgery. Their scans look clear. Their ctDNA levels appear low. By conventional measures, they are in remission. But somewhere, invisible to current detection methods, residual cancer cells may still be present: dormant, waiting, and capable of returning. This is the challenge of Minimal Residual Disease (MRD) and it is one of the most consequential unsolved problems in oncology.
At 1Cell.ai, we developed MIRAGE:- Minimal Residual Assessment using Genome-wide Epigenomics– a proprietary computational algorithm designed to detect MRD with a level of sensitivity that conventional ctDNA methods cannot match.
The Science Behind MIRAGE
When CTCs are undetectable or ctDNA levels fall below the thresholds of conventional detection methods, standard liquid biopsy approaches reach their limits. MIRAGE goes further; leveraging DNA methylation analysis across genome-wide differentially methylated regions (DMRs) to detect the faintest traces of tumour signal, even in cancers with as low as 0.001% circulating tumour fraction.
MIRAGE quantifies methylation by evaluating the number of methylated and unmethylated cytosines at each CpG site across the genome, integrating these values into a composite methylation score that reflects overall hyper- or hypomethylation. This score is then normalised against a predefined cut-off established from a reference cohort of non-cancerous healthy individuals, enabling standardised, reproducible clinical interpretation.
Validated Results
Our validation study tested MIRAGE across 156 samples:- including 127 clinical samples (64 tumour samples and 63 non-cancerous healthy controls):
- Specificity of 96.8% across 127 clinical samples, demonstrating that MIRAGE reliably distinguishes true tumour signal from background noise
- 64% of clinical tumour samples (n=41/64) were detected as ctDNA-positive, demonstrating an overall sensitivity of 64.1%
The algorithm demonstrated robust performance across the full spectrum of tumour fractions tested.
Why This Matters
MRD detection is the next frontier in oncology; and it may be the most important one. The ability to detect residual disease after surgery or treatment, before it becomes radiologically or clinically apparent, gives oncologists a crucial window to intervene; adjusting therapy, intensifying surveillance, or enrolling patients in clinical trials while the disease is at its most treatable.
MIRAGE is our contribution to closing that window- giving oncologists a powerful, validated, non-invasive tool to see what conventional methods cannot.
Presented by Dr. Gowhar Shafi et al | April 20, 2026 | Session PO.MCB06.01
Presented at the AACR Annual Meeting 2026, San Diego, CA | April 17–22, 2026 | #AACR26