ctDNA blood test developments in cancer monitoring

Recent research highlights the growing utility of circulating tumor DNA (ctDNA) blood tests as biomarkers for monitoring various cancers.

In lung cancer management, findings from the NeoCOAST-2 trial suggest that measuring ctDNA can help predict treatment outcomes for patients with operable non-small cell lung cancer. Analysis presented at the ESMO Congress 2026 indicates that patients whose ctDNA becomes undetectable during therapy, such as those receiving combinations of immunotherapy with chemotherapy or agents like oleclumab, monalizumab, or datopotamab deruxtecan, are more likely to remain free of cancer-related events. This tumor-agnostic approach allows clinicians to assess treatment response before surgery, rather than waiting for post-surgical pathological results.

Further research published in The Journal of Molecular Diagnostics suggests that combining liquid biopsies with computed tomography (CT) scans may improve detection. Integrating ctDNA data with imaging into computer models could help identify minimal residual disease months before it is visible on traditional imaging, potentially helping doctors decide on additional treatments or helping patients avoid unnecessary interventions.

In breast cancer, studies indicate that tissue-free epigenomic assays provide high prognostic value for detecting recurrence in early-stage patients, showing a sensitivity of 73% within one year. Monitoring ctDNA can also identify mutations like those in the ESR1 gene, which signal resistance to endocrine therapy. The SERENA-6 study indicates that monitoring ctDNA can identify these genetic mutations before they become visible on imaging, which may reduce the risk of disease progression.