Rubin on Point
Cancer isn’t just about mutations. In Part 2 of this conversation, Dr. Brandon Guida breaks down how epigenomics is transforming the way we detect, monitor, and understand cancer in real time. If Part 1 explained the “operating system,” this episode shows how that system becomes a fingerprint for disease—and how we can actually measure it. We dive into: * How epigenomic patterns create a detectable cancer signature * The difference between ctDNA vs cfDNA * Why methylation increases sensitivity in cancer detection * How tumors evolve (and why treatment can stop working) * What tumor fraction really means—and why it matters * The clinical gap: why this data isn’t used enough (yet) This is where diagnostics meet precision medicine. And where the future of oncology is heading. ⏱️ CHAPTERS 00:00 – Welcome back + Part 1 recap 00:52 – Epigenomics in cancer: what changes 53:31 – Cancer “fingerprints” explained 54:29 – Multi-cancer early detection tests 55:14 – ctDNA vs cfDNA (the “haystack” analogy) 57:20 – The future: multi-modal diagnostics 58:04 – Why epigenomics improves detection sensitivity 01:00:11 – Mutations vs epigenetic changes 01:01:20 – Why methylation gives more signal 01:02:32 – BRCA: mutation vs epigenetic silencing 01:04:09 – Why testing matters (if you’re looking for it) 01:07:18 – Tp53 explained (and why it’s a big deal) 01:13:58 – Clonal evolution + treatment resistance 01:15:50 – Tumor fraction: how it’s calculated 01:16:52 – When treatment looks like it’s working—but isn’t 01:18:10 – Why clinicians aren’t using this enough (yet)
40 episodios
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