Founder Mode Oncology

Systematic framework for navigating personalized cancer treatment, generalized from Sid Sijbrandij's osteosarcoma case (2022-2026). Transforms the ad-hoc "billionaire with a team" approach into a reproducible methodology using open-source tools and structured decision-making.

The Three-Pillar Framework

Pillar 1: Maximal Diagnostics

Run every available diagnostic modality to build a complete molecular picture. Standard clinical panels miss non-obvious targets.

Minimum diagnostic stack (in priority order):

1. Genomics: WGS + WES (tumor/normal paired) — somatic mutations, CNV, structural variants
2. Transcriptomics: Bulk RNA-seq + scRNA-seq (tumor + PBMCs) — gene expression, immune landscape, non-obvious targets
3. Liquid biopsy: ctDNA (tumor-informed, e.g. Signatera) + methylation-based (e.g. Northstar) — real-time monitoring
4. Functional testing: Organoid drug testing + mass response assays — empirical drug sensitivity
5. Imaging: Standard (CT/MRI) + novel PET tracers (68Ga-FAP, 68Ga-B7H3) — target validation
6. Flow cytometry: B/T cell subsets — immune status tracking