Ground Truths

This week Tony Wyss-Coray and I published an invited review paper in Nature Medicine entitled “Biological Aging Clocks in Health and Disease.” The concepts and content of the paper may be difficult to understand for people not working in life science, but they are groundbreaking and have exciting implications for the future of medicine. So this edition of Ground Truths is intended to make all of the progress comprehensible for you and to hopefully see the coming inflection point in medicine.

The tumor microenvironment (TME), composed of immune cells, fibroblasts, and endothelial cells, has emerged as critical to pathogenesis, prognosis and treatment for cancer (schematic Figure below). There’s no such thing as TMI (too much information) for TME! Yet there’s still no way of assessing it in the clinic by a blood test, and even by invasive biopsy the sampling bias for TME without broader geographic context can lead to important mistakes. That isn’t used for clinical decision making.

“I may be the expert in cancer, but you are the expert in you.”—Elisa Port, MD Ground Truths is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

It was just a matter of time. Agentic autonomous AI has already been applied to life science and many other domains, and today there were 2 notable publications in Nature that move this concept forward for healthcare. One is called MIRA from Jacob Kather and colleagues from Germany, and the other is called AIME, from Mike Schaekermann and colleagues at Google (acronyms defined below).

In the journal Cell, a team of >80 researchers from 4 continents reported on the discovery of a 14-protein blood test which paved the way for predicting and preventing lung cancer more than 5 years before it would be diagnosed. Current efforts in cancer are largely directed to therapy and early detection, with only a very limited foray to prevention.

Helen Pearson, PhD, is an award-winning biomedical journalist at Nature, named European Science Journalist of the Year in 2025. She teaches science writing at University College London. BEYOND BELIEF is her second, just published book. THE LIFE PROJECT was her first.

It has been 15 years since the first unequivocal proof that an immune checkpoint inhibitor (anti-CTLA-4, the T cell receptor shown in blue below; pink represents the antibody) was shown to extend survival in patients with metastatic melanoma and received FDA approval. The 2013 Breakthrough of the Year for Science Magazine was cancer immunotherapy, recognizing unleashing the brakes of T cells for some remarkably improved outcomes for patients with a variety of refractory cancers.

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Joanna Stern was the Wall Street Journal technology journalist for 12 years. She’s an Emmy award winner for her documentary E-Ternal, and recently started her own company New Things, with added advice from ChatGPT! Over the years at WSJ, I relied on Joanna’s reviews of technology for many purchases (and things I avoided) reflecting her keen and brutal assessments. I also had fun working with her on some of her video assessments of health technologies.