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For more than a decade, Scott Bratman has worked at the forefront of liquid biopsy innovation – developing noninvasive approaches to cancer detection that rely on a simple tube of blood.

Bratman’s research began at Stanford University, where first-generation tests focused on identifying mutations in circulating DNA. These were revolutionary at the time, offering a new window into advanced cancer biology, but the tests struggled with early detection and provided limited tissue specificity.

Bratman joined forces at the University of Toronto with Dr. Daniel De Carvalho, now CSO of Adela, , at University Health Network in Toronto to explore a more powerful biomarker: DNA methylation. Unlike mutations, methylation patterns offer a broader and more contextual signal—capturing not just the presence of cancer, but clues about where it originates and how it evolves. Their collaboration produced a breakthrough: a test capable of picking up on multiple early-stage cancers that became the foundation for Adela. Adela’s proprietary approach avoids chemical damage to DNA, allowing for a new generation of high-resolution diagnostics. Bratman shares how this technology moved from bench to bedside and is helping to usher in a new era for cancer diagnostics.

You started in cancer diagnostics during your training. What led you to found Adela?

I am a clinician scientist with a background in oncology and have worked in the liquid biopsy field for the past 15 years. My training began at Stanford University, where I studied approaches to detect cancer in the bloodstream. I later established a research lab in Toronto, where I partnered with Adela’s CSO Daniel De Carvalho, to address the limitations of first-generation liquid biopsy tests. Our work focused on leveraging DNA methylation to improve detection performance, laying the scientific foundation for the founding of Adela.

Was there a specific “a-ha moment” where you knew you had found something viable as a company moving forward?

Yes. In those early days of liquid biopsy, we could basically detect advanced cancers and find specific mutations linked to resistance or sensitivity to targeted therapies. That was a breakthrough back then, but we lacked the tools to address the full spectrum of cancer, particularly early detection and molecular residual disease after treatment. We focused our efforts on unlocking new technologies using DNA methylation to expand the clinical utility of liquid biopsy.

The “a-ha” moment came from early work in our labs. We saw the potential for detecting not just one, but seven different cancers at early stages from a small blood sample and with a single

test. That was unprecedented at the time. It got us thinking about how far this could go in cancer diagnostics across the full spectrum of disease.

Why methylation patterns? Why are they such powerful biomarkers for cancer?

DNA methylation underlies the development of cells at the earliest stages of differentiation into tissues. Dysregulation of this process can lead to cancers. Because we see this across cancer types and tissue types, DNA methylation in the blood can be used to detect the presence of cancer and identify which tissues are shedding DNA into the bloodstream.

Prior to this, most work focused on DNA mutations, which don’t have that same tissue-type specificity. The challenge historically was that profiling methylation required chemical treatments that degraded the DNA, resulting in a lower signal-to-noise ratio. The platform technology we developed focused on preserving that precious material within a small tube of blood so we could analyze it accordingly.

What makes your approach distinct from peers in your field?

What makes our approach unique is that we use a signal-preserving assay. We do not degrade DNA; instead, we simultaneously enrich the informative, methylated regions within a blood sample and target those for sequencing and analysis.

By having a single assay platform, we can generate data that feeds into analytical models for machine learning to develop signatures for different diseases. We think of it as an engine. We maintain a single platform, derive insights from every sample, and feed a continuous learning machine that gives rise to different products. That is a massive differentiator compared to fixed panels or specific biomarkers.

Adela originally focused on multi-cancer early detection (MCED), but molecular residual disease (MRD) has been a major emphasis recently. How are you balancing those ambitions?

We believe our platform has broad potential across all areas of cancer diagnostics, but we have chosen to strategically focus on applications with strong demand and immediate clinical utility. MRD represents a particularly tangible, near-term opportunity, as it pertains to patients who already have a cancer diagnosis and require rapid, informed clinical decision-making.

Today, therapy response is primarily monitored using medical imaging, such as CT or MRI scans, which have limited sensitivity, are expensive, and often require patients traveling to specialized centers. A blood test that can complement or even replace standard imaging offers a powerful advantage for both patients and physicians.

You mentioned patients traveling to specialized centers. Can you talk about the impact this technology could have on accessibility?

This technology was invented in Canada, a vast country where most of the population is concentrated in a few cities, leaving large regions with sparsely populated communities. These communities often have poor access to specialized medical imaging. Improving accessibility is fundamental to the origin story of Adela, as we believe a blood test can bring advanced cancer management closer to patients in these disparate communities.

Another key challenge is “tissue accessibility.” Many existing MRD tests require a tumor tissue specimen, adding time, cost, and often making testing impossible for patients without sufficient tumor material. For example, in head and neck cancer, over a third of patients are estimated to lack sufficient tissue for these tests. A tissue-free test removes this barrier, enabling accessible cancer management for a much broader patient population.

What are some of the most important lessons that you’ve learned building a company in this space?

Given my background as a researcher and technology inventor, I have sometimes been at risk of tunnel vision. Early on in founding Adela, I quickly realized the importance of partnering with people whose expertise complemented my own. People who had successfully brought products to market and navigated the complexities of fundraising in a competitive space such as cancer diagnostics. I have learned a tremendous amount from mentors and partners along the way during this journey with Adela. Building the right team from the outset created a foundation that allows us to keep patients at the center of what we do.

What is the roadmap for the next 12 to 24 months?

We are very excited about the upcoming launch of our MRD test for use in head and neck cancer, which addresses a significant unmet need in monitoring for recurrence in patients who have completed treatment. Building on that momentum, we recently had a publication accepted on immunotherapy response monitoring. This second product is particularly important because it shows the continuity of our platform across both early-stage and more advanced-stage disease.

We plan to launch the immunotherapy product next, while continuing to advance MRD development for other indications. Simultaneously, we have a large multi-cancer early detection study underway, and we look forward to generating more data in that space as well.

What advice would you offer to others looking to translate a basic discovery into real-world impact?

Technology today is powerful, with seemingly limitless opportunities to push the envelope of what is possible. But at the end of the day, you must ask: What do the data mean for the patient? How does it improve the partnership between the physician and the health system? These questions serve as our guiding light in the development of every test we create.