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Article History

Received: 14 November 2024

Accepted: 9 October 2025

First Online: 22 December 2025

Competing interests

: The Johns Hopkins University has filed patent applications related to technologies described in this paper, including patent WO 2025/007013, on which S.P., T.D.N., J.G., B.V., K.W.K., N.P. and S.Z. are listed as inventors. S.P. is a consultant to Merck, owns equity in Gilead and received payments from IQVIA and Curio Science. S.P., M.F.K., B.V., K.W.K. and S.Z. are founders and hold equity in TBD Pharma. C.B. and N.P. hold equity in TBD Pharma. B.V., K.W.K. and N.P. are founders of Thrive Earlier Detection, an Exact Sciences Company and hold equity in Haystack Oncology and CAGE Pharma. K.W.K. and N.P. are consultants to Exact Sciences. B.V., K.W.K., N.P. and S.Z. hold equity in Exact Sciences, and are founders of or consultants to and own equity in CLASP. N.P., B.V. and K.W.K. hold equity in NeoPhore; B.V. and K.W.K. are consultants to NeoPhore. M.F.K. received personal fees from Argenx, Revel Pharmaceuticals, Sanofi and Doximity, all unrelated to this work. M.F.K. is a consultant to Alexion Pharmaceuticals, Allogene, Amgen, Argenx, Atara Biotherapeutics, Bristol Myers Squibb, Legend Biotech, Mucommune, Revel Pharmaceuticals, Sana Biotechnology and Sanofi. M.F.K. received research support from Blackbird Labs, NorthStar Medical Radioisotope and TBD Pharmaceuticals, Inc. B.V. is a consultant for and holds equity in Catalio Capital Management. S.Z. has a research agreement with BioMed Valley Discoveries, Inc. C.B. is a consultant to Depuy-Synthes, Bionaut Labs, Haystack Oncology and Privo Technologies and is a co-founder of OrisDx and Belay Diagnostics. C.H.S. is a consultant to Kyowa Kirin, and has served on advisory boards for Acrotech Biopharma and received honoraria from Medical Logix and Haymarket Medical Education. D.M.P. reports grant and patent royalties through institutions from BMS, a grant from Compugen, stock from Trieza Therapeutics and Dracen Pharmaceuticals and founder equity from Potenza; is a consultant for Aduro Biotech, Amgen, AstraZeneca (Medimmune/Amplimmune), Bayer, DNAtrix, Dynavax Technologies Corporation, Ervaxx, FLX Bio, Rock Springs Capital, Janssen, Merck, Tizona and ImmunomicTherapeutics; and is on the scientific advisory board of Five Prime Therapeutics, Camden Nexus II and WindMil and on the board of directors for Dracen Pharmaceuticals. C.G.M. serves on the advisory board of Illumina, reports speaking fees from Amgen and has received funding from Pfizer and royalties from Cyrus. J.D. is a consultant to Clasp Therapeutics and Hemogenyx. The companies named above, as well as other companies, have licensed previously described technologies related to the work described in this paper from Johns Hopkins University. S.P., T.D.N., J.G., B.V., K.W.K., N.P. and S.Z. are inventors of some of these technologies. Licenses to these technologies are or will be associated with equity or royalty payments to the inventors as well as to Johns Hopkins University. Patent applications on the work described in this paper may be filed by Johns Hopkins University. The terms of all these arrangements are being managed by Johns Hopkins University following its conflict-of-interest policies. The remaining authors declare no competing interests.