Detecting cancer's chaos with fragmentomics - DELFI

Our latest episode features Susan Tousi, CEO of DELFI Diagnostics and former Chief Commercial Officer at Illumina, where she witnessed the cost of genomic sequencing plummet from $100,000 to $100. That transformation sparked a mission: harness accessible genomics to catch cancer early.

DELFI, which stands for "DNA Evaluation of Fragments for Early Interception," takes a fundamentally different approach to liquid biopsy. Rather than expensive targeted sequencing that hunts for specific mutations, Delfi's fragmentomics platform analyzes the structural chaos that tumors create when they shed DNA into the bloodstream. Think of it as inspecting whether a book is damaged rather than proofreading every word.

Their first commercial product, First Look Lung, addresses the deadliest cancer, which claims 125,000 American lives annually. The blood-based test achieves 75% sensitivity for stage one lung cancer, where 10-year survival reaches 73%. A negative result means 99.8% confidence the patient is cancer-free; a positive result indicates they're 5.2 times more likely to have cancer, providing powerful motivation for follow-up CT imaging.

Because DELFI sequences the whole genome, the same lab workflow can detect multiple cancers simply by applying different AI algorithms. They've already published data on the seven deadliest cancers, including pancreatic, liver, and ovarian.

This episode is a must-listen for anyone interested in early cancer detection, liquid biopsy innovation, or how AI and genomics are converging to make screening more accessible and affordable.