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Pillar 4 · Surveillance After Curative-Intent Treatment

Clear — Overview

PILLAR 4 · SURVEILLANCE AFTER CURATIVE-INTENT TREATMENT

Clear is OnKommon’s molecular residual disease (MRD) service — continuous surveillance for people who have completed curative-intent treatment and want the earliest possible warning if cancer returns. It watches, in the background, for the faint molecular signal of disease long before a scan could see it, so that if something changes, you and your team can act early.

Learn How Clear Works MRD Surveillance

Decoder · MRD (molecular residual disease)

After surgery or curative-intent treatment, scans may look clear even when a tiny number of cancer cells remain — too few to see. Those cells can still shed ctDNA into the blood. Molecular residual disease (MRD) testing looks for that trace ctDNA, so a return of cancer can often be flagged months before it would appear on imaging.

Why It Matters

2 · Why it matters

After curative-intent treatment, Clear offers the earliest possible warning and peace of mind.

Earlier warning

Trace ctDNA can flag returning disease months ahead of imaging — when more options may be open.

Peace of mind

Between scans, Clear offers reassurance grounded in molecular data, not just waiting.

Personalised follow-up

Results can inform how closely you are watched and when to investigate.

Clear vs Sentinel

3 · Clear vs Sentinel

After treatment vs during treatment.

After treatment (Clear)

Clear is for the period after curative-intent treatment, when scans are clear and the goal is to catch any return as early as possible (MRD surveillance).

During treatment (Sentinel)

Sentinel is for people on active treatment for advanced disease, watching whether therapy is working and flagging resistance.

Same liquid-biopsy science, two different chapters of the journey.

The Two Clear Tests

4 · The two Clear tests

Clear Blood or Clear Solid — choose the right test for your cancer.

Clear Blood

For blood-based / haematological contexts
  • For: Blood-based / haematological contexts — leukaemia, lymphoma, myeloma.
  • Sample: Blood draw
  • Purpose: MRD surveillance

Clear Solid

For solid tumours after curative-intent treatment
  • For: Solid tumours after curative-intent treatment — lung, breast, colon, prostate, and others.
  • Sample: Blood draw
  • Purpose: MRD surveillance
How It Works

5 · How it works

Continuous surveillance, planned intervals.

Establish Baseline

A baseline is established, then Clear monitors at planned intervals as a subscription.

Monitor at Intervals

Each result is interpreted in context; a rising or newly-detected signal triggers a clinician review through KPCIRC, not an automated alarm.

Clinician Review

Each result is interpreted in context; a rising or newly-detected signal triggers a clinician review through KPCIRC, not an automated alarm.

Pricing

6 · Pricing

Clear is offered as a monitoring subscription.

Clear is offered as a monitoring subscription. The schedule and price are confirmed at consultation based on your cancer type and follow-up plan.

Research & Evidence

RESEARCH & EVIDENCE

The science behind this

Clear uses ctDNA-based MRD detection — among the most actively validated ideas in oncology today.

Study 1 · Post-surgery ctDNA predicts recurrence

In stage II colon cancer, detectable ctDNA after surgery identified patients at much higher risk of recurrence — well before imaging changed.

Tie J, et al. Science Translational Medicine, 2016.

Study 2 · Confirmed at large scale

Across 2,240 patients, ctDNA positivity during the post-surgery “MRD window” was strongly associated with worse disease-free and overall survival.

Nakamura Y, et al. (CIRCULATE-Japan GALAXY) Nature Medicine, 2024.

Study 3 · It can guide treatment intensity

A randomized trial showed a ctDNA-guided approach let many patients safely avoid adjuvant chemotherapy without a higher recurrence rate.

Tie J, et al. (DYNAMIC) New England Journal of Medicine, 2022.

These independent, peer-reviewed studies describe the class of technology OnKommon uses. They are shared for education; they are not results for any individual and are not a promise of benefit.

Terminology

TERMINOLOGY ON THIS PAGE

The words you will see, in plain language

Term / What it means
MRDMolecular residual disease — microscopic disease left after treatment, seen as trace ctDNA.
ctDNACirculating tumour DNA — tumour DNA fragments a blood test can read.
Tumour-informedAn MRD test designed from your own tumour's mutations, for higher sensitivity.
RecurrenceThe cancer returning after a period of remission.
Lead timeHow far ahead of a scan a blood test can flag returning disease.
Transparency

TRANSPARENCY — WHAT WE DO AND DON’T

Being clear about our limits

What we DO

  • Watch for returning disease after curative-intent treatment
  • Often flag recurrence earlier than routine imaging
  • Trigger a KPCIRC clinician review on a changing signal
  • Personalise how closely follow-up is done

What we DON'T do

  • Diagnose recurrence on its own — findings are confirmed
  • Detect every recurrence (some tumours shed little ctDNA)
  • Replace your scheduled scans and specialist follow-up
  • Guarantee that acting earlier will change the outcome
Important information about this test

Clear is a genomic (DNA-based) test offered for use by qualified healthcare professionals. It is intended to support — not replace — clinical judgement, and must be interpreted alongside your full clinical history, other investigations, and applicable guidelines.

  • • A result is not a diagnosis and does not by itself decide treatment.
  • • A “not detected” or normal result does not rule out cancer or a genetic change.
  • • Not all cancers release enough DNA into blood to be detected.
  • • The test does not guarantee access to any medicine, its regulatory approval, insurance cover, or that a therapy will work.
  • • Sample-collection kits are for use by qualified phlebotomists only — not for self-testing or self-sampling.
  • • Confirmatory testing may be required.

Regulatory status (India). OnKommon's registration of its genomic tests as in-vitro diagnostic (IVD) medical devices with the Central Drugs Standard Control Organisation (CDSCO) is in progress (IVD class pending). Sequencing and variant calling are performed by an accredited laboratory partner (College of American Pathologists — CAP-accredited; ISO 15189) following international guidelines (ACMG/AMP/ASCO/CAP) using a CE-IVD certified variant database. The OnKommon interpretation engine is provided for research and decision-support use. Marketing follows the Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954 and applicable Indian advertising standards.

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