{"entity":{"id":"ctdna-tests","kind":"roadmap","name":"ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment","aka":["Liquid biopsy roadmap","MRD testing roadmap","Multi-cancer early detection roadmap"],"tldr":"Blood carries fragments of tumour DNA. This roadmap follows the tests that read them, from the first sighting in 1948 to blood tests that now choose a drug, spare chemotherapy, or screen for many cancers at once, and it lists the readouts to watch next.","summary":"Circulating tumour DNA (ctDNA) testing has three jobs, and each is at a different stage. Genotyping from blood is settled: the cobas EGFR plasma test became the first FDA-approved liquid biopsy in June 2016, and Guardant360 CDx and FoundationOne Liquid CDx followed in August 2020 as broad companion diagnostics. Residual disease testing after surgery has crossed from prognosis to action: DYNAMIC showed in 2022 that a ctDNA-guided approach halves chemotherapy in stage II colon cancer without harm, and in May 2026 the FDA approved adjuvant atezolizumab for ctDNA-positive muscle-invasive bladder cancer on IMvigor011, the first drug approval that depends on a ctDNA residual disease result. Escalation for a positive test is not yet proven: ALTAIR missed its endpoint and the MERMAID lung trials closed small.\n\nMulti-cancer early detection is the least settled. Shield won FDA approval for colorectal screening in July 2024 on a single-cancer claim. Galleri has one randomised trial behind it: NHS-Galleri did not reduce stage III and IV cancers combined, its primary endpoint, while reporting fewer stage IV diagnoses, and the FDA's advisory panel considers the test on 23 September 2026. The NCI's Vanguard study is the first randomised US test of the approach and runs to 2029.\n\nThe steps below are grouped by what the evidence allowed at the time. The 'What to watch' list carries registry completion dates and meeting dates as their sources state them. Tumour-informed assays (built from the patient's own tumour sequence) and tumour-naive assays (fixed panels, often methylation-based) compete on sensitivity, turnaround and cost; the roadmap treats that split as a running theme rather than an era.","asOf":"2026-09-21","links":[{"label":"Mandel and Metais: nucleic acids in human blood plasma (C R Seances Soc Biol Fil 1948)","url":"https://europepmc.org/article/MED/18875018"},{"label":"Leon et al.: free DNA in the serum of cancer patients and the effect of therapy (Cancer Research 1977)","url":"https://europepmc.org/article/MED/837366"},{"label":"Diehl et al.: circulating mutant DNA to assess tumour dynamics (Nature Medicine 2008)","url":"https://europepmc.org/article/MED/18670422"},{"label":"Dawson et al.: analysis of circulating tumour DNA to monitor metastatic breast cancer (NEJM 2013)","url":"https://europepmc.org/article/MED/23484797"},{"label":"Bettegowda et al.: detection of circulating tumour DNA in early- and late-stage human malignancies (Science Translational Medicine 2014)","url":"https://europepmc.org/article/MED/24553385"},{"label":"Tie et al.: ctDNA detects minimal residual disease and predicts recurrence in stage II colon cancer (Science Translational Medicine 2016)","url":"https://europepmc.org/article/MED/27384348"},{"label":"AACR: FDA approves first liquid biopsy test for lung cancer patients, 1 June 2016","url":"https://www.aacr.org/blog/2016/06/06/fda-approval-liquid-biopsy-test-lung-cancer/"},{"label":"FDA PMA P150044: cobas EGFR Mutation Test v2 (tissue and plasma)","url":"https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P150044"},{"label":"FDA PMA P200010: Guardant360 CDx, approved 7 August 2020","url":"https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P200010"},{"label":"FDA PMA P190032: FoundationOne Liquid CDx, approved 26 August 2020","url":"https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P190032"},{"label":"Natera: final Medicare coverage for Signatera in stage II-III colorectal cancer, 3 September 2020","url":"https://www.natera.com/company/news/natera-receives-final-medicare-coverage-for-its-signatera-mrd-test-in-stage-ii-iii-colorectal-cancer-2/"},{"label":"CMS article A58456: MolDX minimal residual disease testing for solid tumour cancers (revision effective 1 January 2026)","url":"https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58456"},{"label":"DYNAMIC: ctDNA analysis guiding adjuvant therapy in stage II colon cancer (NEJM, 16 June 2022)","url":"https://europepmc.org/article/MED/35657320"},{"label":"DYNAMIC five-year outcomes (Nature Medicine 2025)","url":"https://europepmc.org/article/MED/40055522"},{"label":"GALAXY: molecular residual disease and efficacy of adjuvant chemotherapy in colorectal cancer (Nature Medicine 2023)","url":"https://europepmc.org/article/MED/36646802"},{"label":"CIRCULATE-Japan: ctDNA-guided adaptive platform trials, design of GALAXY, VEGA and ALTAIR (Cancer Science 2021)","url":"https://europepmc.org/article/MED/33931919"},{"label":"ALTAIR: post-adjuvant trifluridine/tipiracil in ctDNA-positive resected colorectal cancer, primary endpoint not met (Nature Medicine 2026)","url":"https://europepmc.org/article/MED/42260101"},{"label":"IMvigor011: ctDNA-guided adjuvant atezolizumab in muscle-invasive bladder cancer (NEJM 2025)","url":"https://europepmc.org/article/MED/41124204"},{"label":"FDA approves atezolizumab for adjuvant treatment of muscle invasive bladder cancer with ctDNA molecular residual disease, 15 May 2026","url":"https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-atezolizumab-adjuvant-treatment-muscle-invasive-bladder-cancer-patients-molecular"},{"label":"PATHFINDER: blood-based tests for multicancer early detection (The Lancet 2023)","url":"https://europepmc.org/article/MED/37805216"},{"label":"FDA PMA P230009: Shield blood-based colorectal cancer screening test, approved 26 July 2024","url":"https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P230009"},{"label":"GRAIL: full results from the NHS-Galleri trial, 30 May 2026","url":"https://grail.com/press-releases/grail-reports-full-results-from-nhs-galleri-trial-demonstrating-substantial-reduction-in-stage-iv-cancer-diagnoses-at-2026-asco-annual-meeting/"},{"label":"GRAIL: PATHFINDER 2 results in more than 35,000 participants, 31 May 2026","url":"https://grail.com/press-releases/grail-presents-pathfinder-2-results-of-more-than-35000-participants-showing-the-galleri-test-substantially-increased-cancer-detection-with-robust-performance-and-favorable-safety-at-2026-a/"},{"label":"GRAIL: FDA advisory committee meeting on the Galleri PMA set for 23 September 2026","url":"https://grail.com/press-releases/grail-announces-fda-advisory-committee-meeting-to-review-premarket-approval-application-for-the-galleri-multi-cancer-early-detection-test/"},{"label":"ClinicalTrials.gov NCT06995898","url":"https://clinicaltrials.gov/study/NCT06995898"},{"label":"ClinicalTrials.gov NCT05174169","url":"https://clinicaltrials.gov/study/NCT05174169"},{"label":"ClinicalTrials.gov NCT04050345","url":"https://clinicaltrials.gov/study/NCT04050345"},{"label":"ClinicalTrials.gov NCT04660344","url":"https://clinicaltrials.gov/study/NCT04660344"},{"label":"ClinicalTrials.gov NCT05155605","url":"https://clinicaltrials.gov/study/NCT05155605"}],"tags":["ctdna","liquid-biopsy","mrd","mced"],"related":["diagnostics-roadmap","early-detection-roadmap","cure-paths","ctdna-mrd-to-adjuvant","idea-ctdna-guided-adjuvant-crc","idea-tr2-ctdna-mrd-qualification","idea-bio2-mrd-coverage-with-evidence","idea-prev-mced-positive-resolution-pathway"],"cancers":[],"sections":["diagnostics","early-detection"],"technologies":["liquid-biopsy","mrd-testing","mced","cfdna-methylation-testing","fragmentomics","continuous-ctdna-monitoring","methylation-profiling","companion-diagnostic"],"targets":[],"drugs":["cobas-egfr-mutation-test","guardant360-cdx","foundationone-cdx","signatera","guardant-reveal","radar-mrd","galleri","shield"],"companies":["roche-genentech","guardant-health","foundation-medicine","natera","grail","exact-sciences","freenome","delfi-diagnostics"],"institutions":[],"pathways":[],"terms":["cfdna","ctdna","mrd","tumour-informed-assay","de-escalation","stage-shift","ppv","surrogate-validation"],"trials":["dynamic","circulate-japan","imvigor011","tracc","bespoke-crc","mermaid-1","mermaid-2","circulate-us","pathfinder-2","nhs-galleri","eclipse-shield","vanguard-study"],"people":["nitzan-rosenfeld","dawson-sarah-jane","nickolas-papadopoulos","alberto-bardelli","jeanne-tie","thomas-powles","deb-schrag","peter-sasieni","klaus-pantel"],"bottlenecks":["b-dormancy-mrd"],"keyPapers":["paper-dynamic-nejm-2022","paper-galaxy-signatera-nat-med-2023","paper-imvigor011-nejm-2025","paper-pathfinder-lancet-2023","paper-nhs-galleri-design-cancers-2022"],"journals":[],"dependsOn":[],"notes":["How this stays current: run `npm run ctdna:watch`. The script reads this roadmap, lists every trial it references with its corpus status, checks each NCT id against the ClinicalTrials.gov v2 API for overall status and completion dates, and searches Europe PMC for papers on the trial acronyms published since the roadmap's asOf date. Anything it prints that this page does not say is an edit to make; then move asOf forward.","Dates in 'What to watch' are quoted from registries and releases and are not predictions. Registry completion dates move, and a company release is used only for a meeting date or a readout date, never for a result the paper has not yet reported."],"steps":[{"era":"1948-1994","title":"A curiosity in plasma","description":"Mandel and Metais reported nucleic acids in human blood plasma in 1948, and in 1977 Leon and colleagues found that people with cancer carried more free DNA in their serum and that levels fell when treatment worked. Nobody could yet say which fragments came from the tumour, so for four decades this stayed an observation rather than a test.","refs":["cfdna","ctdna","liquid-biopsy","klaus-pantel"],"status":"historic"},{"era":"2008-2016","title":"Proof that blood tracks the tumour","description":"Digital PCR and deep sequencing made it possible to count tumour-specific mutations in plasma: Diehl and colleagues showed mutant DNA rising and falling with disease in 2008, Dawson and colleagues tracked metastatic breast cancer with it in 2013, and Bettegowda and colleagues detected ctDNA across early- and late-stage cancers in 2014. Tie and colleagues then showed in 2016 that ctDNA found after surgery for stage II colon cancer predicted recurrence, the observation the residual disease trials were built on.","refs":["ctdna","liquid-biopsy","nitzan-rosenfeld","dawson-sarah-jane","nickolas-papadopoulos","alberto-bardelli","jeanne-tie","clonal-evolution"],"status":"historic"},{"era":"2016-2020","title":"Regulators accept a blood genotype","description":"On 1 June 2016 the FDA approved the cobas EGFR Mutation Test v2 for plasma, the first liquid biopsy companion diagnostic, letting lung cancer patients start erlotinib on a blood result when tissue was unavailable. Two broad panels followed in August 2020: Guardant360 CDx on 7 August and FoundationOne Liquid CDx on 26 August, each a companion diagnostic for several drugs, with a negative blood result sent back to tissue testing.","refs":["cobas-egfr-mutation-test","guardant360-cdx","foundationone-cdx","companion-diagnostic","roche-genentech","guardant-health","foundation-medicine","erlotinib","osimertinib"],"status":"historic"},{"era":"2019-2021","title":"Tumour-informed residual disease tests reach the clinic and the payer","description":"Signatera sequences each patient's tumour, picks 16 mutations, and looks for them in plasma after surgery; in the GALAXY registry a positive test four weeks after colorectal surgery carried a tenfold higher recurrence risk. Medicare's MolDX programme finalised coverage for serial Signatera testing in stage II and III colorectal cancer on 3 September 2020, and its coverage article for residual disease tests now lists several tests and cancers, which is how tumour-informed testing became routine before any randomised trial had finished.","refs":["signatera","natera","mrd-testing","mrd","tumour-informed-assay","guardant-reveal","radar-mrd","paper-galaxy-signatera-nat-med-2023","circulate-japan","medicare-ced"],"status":"current"},{"era":"2022-2026","title":"Randomised trials: sparing treatment works, adding it is harder","description":"DYNAMIC, published in June 2022, randomised 455 people with stage II colon cancer and cut adjuvant chemotherapy from 28 percent to 15 percent with two-year recurrence-free survival of 93.5 against 92.4 percent; the five-year update in 2025 held at 88 against 87 percent. Escalation has been harder to prove: ALTAIR, which gave trifluridine/tipiracil to ctDNA-positive patients after colorectal surgery, did not meet its disease-free survival endpoint, the MERMAID lung trials closed with 89 and 30 participants, and TRACC, BESPOKE and CIRCULATE-Japan's VEGA de-escalation trial are still running.","refs":["dynamic","paper-dynamic-nejm-2022","circulate-japan","tracc","bespoke-crc","mermaid-1","mermaid-2","ctdna-mrd-to-adjuvant","de-escalation","trifluridine-tipiracil","colorectal"],"status":"current"},{"era":"2025-2026","title":"The first drug approval that depends on a ctDNA result","description":"IMvigor011 tested 761 people after cystectomy for muscle-invasive bladder cancer and randomised the 250 whose blood turned ctDNA-positive to atezolizumab or placebo: disease-free survival hazard ratio 0.64 and overall survival hazard ratio 0.59, published in NEJM in December 2025. On 15 May 2026 the FDA approved adjuvant atezolizumab for patients with ctDNA molecular residual disease after cystectomy, with Signatera CDx as the companion diagnostic, so a residual disease blood test now sits inside a drug label.","refs":["imvigor011","paper-imvigor011-nejm-2025","atezolizumab","signatera","thomas-powles","urothelial","companion-diagnostic"],"status":"current"},{"era":"2021-2026","title":"Screening from blood: one cancer approved, many cancers under review","description":"PATHFINDER, published in 2023, was the first prospective test of a multi-cancer blood test in 6,621 adults without symptoms: 1.4 percent had a signal, 38 percent of those had cancer, and resolving a positive took a median of 79 days. Shield became the first FDA-approved blood test for colorectal cancer screening on 26 July 2024, for average-risk adults aged 45 and over with colonoscopy after a positive. NHS-Galleri, the randomised trial of Galleri in 142,250 people in England, reported on 30 May 2026 that stage III and IV cancers combined were not reduced (the primary endpoint) while stage IV diagnoses fell by 14 percent; PATHFINDER 2 reported a positive predictive value of 60.3 percent in 35,878 people the next day, and GRAIL's premarket application, filed on 29 January 2026, goes to an FDA advisory panel on 23 September 2026.","refs":["mced","galleri","shield","grail","guardant-health","pathfinder-2","nhs-galleri","eclipse-shield","paper-pathfinder-lancet-2023","paper-nhs-galleri-design-cancers-2022","cfdna-methylation-testing","stage-shift","ppv","deb-schrag","peter-sasieni"],"status":"current"},{"era":"2026-2029","title":"The randomised answers arrive","description":"The open questions each have a trial with a date on the registry. For screening, the NCI's Vanguard study randomises 24,000 people to multi-cancer detection tests or usual care, with primary completion listed for 31 January 2029, and NHS-Galleri's follow-up continues. For residual disease, CIRCULATE-US randomises stage III colon cancer patients by Signatera result to more or less chemotherapy (primary completion 10 March 2029), TRACC follows 1,000 people to 2029, and VEGA asks whether ctDNA-negative patients can skip chemotherapy altogether. If escalation trials keep missing, the field's case will rest on de-escalation and on ctDNA as a surrogate endpoint.","refs":["vanguard-study","circulate-us","tracc","circulate-japan","nci","nrg-oncology","idea-ctdna-guided-adjuvant-crc","idea-tr2-ctdna-mrd-qualification","surrogate-validation"],"status":"emerging"},{"era":"2026-2030","title":"Deeper, cheaper and tumour-naive","description":"Two technical routes are competing to make the tests more sensitive without a tumour sample: methylation, which reads chemical marks that also point to the tissue of origin, and fragmentomics, which reads the sizes and positions of the fragments themselves. Whole-genome approaches and repeated sampling aim to catch relapse earlier than a three-monthly draw. The gating question for all of them is utility rather than sensitivity: finding disease earlier has to change an outcome, and the clonal haematopoiesis of normal blood cells is the main source of false positives.","refs":["cfdna-methylation-testing","fragmentomics","methylation-profiling","continuous-ctdna-monitoring","delfi-diagnostics","freenome","guardant-reveal","clonal-haematopoiesis","mrd-kinetics-models","idea-bio2-whole-genome-mrd-depth","idea-bio1-methylation-clone-tracking"],"status":"emerging"},{"era":"What sets the pace","title":"Payment, standards and what to do with a positive","description":"In the United States, Medicare pays for residual disease tests through a MolDX coverage article that names tests and cancers one at a time (revision effective 1 January 2026); screening tests need their own coverage route, and most health systems outside the United States pay for none of this yet. Laboratories run different assays with no shared reference material, so a positive in one is not a positive in another, and a screening positive still needs a fast, agreed diagnostic pathway. Coverage with evidence, reference plasma standards and a national positive-result pathway are the proposals on the table.","refs":["medicare-ced","fda-ldt-rule","idea-bio2-mrd-coverage-with-evidence","idea-tr2-ctdna-reference-plasma","idea-bio2-mrd-reference-standards","idea-prev-mced-positive-resolution-pathway","b-dormancy-mrd"],"status":"current"}],"watch":[{"item":"FDA Molecular and Clinical Genetics Panel reviews the Galleri premarket approval application","expected":"2026-09-23","source":"https://grail.com/press-releases/grail-announces-fda-advisory-committee-meeting-to-review-premarket-approval-application-for-the-galleri-multi-cancer-early-detection-test/","refs":["galleri","grail","mced"]},{"item":"IMvigor011 study completion on the registry; longer follow-up of ctDNA-negative patients under surveillance","expected":"2026-10-01","source":"https://clinicaltrials.gov/study/NCT04660344","refs":["imvigor011","atezolizumab"]},{"item":"NHS-Galleri: peer-reviewed publication and continued follow-up; the release gives no mortality data","source":"https://grail.com/press-releases/grail-reports-full-results-from-nhs-galleri-trial-demonstrating-substantial-reduction-in-stage-iv-cancer-diagnoses-at-2026-asco-annual-meeting/","refs":["nhs-galleri","galleri","stage-shift"]},{"item":"ECLIPSE (Shield) study completion on the registry","expected":"2027-08-05","source":"https://clinicaltrials.gov/study/NCT04136002","refs":["eclipse-shield","shield"]},{"item":"PATHFINDER 2 study completion (primary completion listed as 2026-02-11)","expected":"2028-04-30","source":"https://clinicaltrials.gov/study/NCT05155605","refs":["pathfinder-2","galleri"]},{"item":"Vanguard study primary completion: the NCI's randomised feasibility trial of multi-cancer detection tests in 24,000 people","expected":"2029-01-31","source":"https://clinicaltrials.gov/study/NCT06995898","refs":["vanguard-study","nci"]},{"item":"CIRCULATE-US primary completion: ctDNA-guided escalation and de-escalation of adjuvant chemotherapy in stage III colon cancer","expected":"2029-03-10","source":"https://clinicaltrials.gov/study/NCT05174169","refs":["circulate-us","signatera"]},{"item":"TRACC primary completion: 1,000 people with early colorectal cancer followed by ctDNA","expected":"2029-07-31","source":"https://clinicaltrials.gov/study/NCT04050345","refs":["tracc"]},{"item":"VEGA (CIRCULATE-Japan): non-inferiority of no chemotherapy in ctDNA-negative colon cancer; no readout date in the sources read","source":"https://europepmc.org/article/MED/33931919","refs":["circulate-japan"]},{"item":"BESPOKE CRC: registry status not updated since a listed completion of September 2025; watch for the primary publication","expected":"2025-09","source":"https://clinicaltrials.gov/study/NCT04264702","refs":["bespoke-crc","signatera"]}]},"route":"/roadmaps/ctdna-tests/","neighbours":{"roadmap":[{"id":"diagnostics-roadmap","kind":"roadmap","name":"Diagnostics roadmap: stains → gene panels → blood tests that decide treatment","route":"/roadmaps/diagnostics-roadmap/"},{"id":"early-detection-roadmap","kind":"roadmap","name":"Early detection roadmap: organ screening → blood tests for many cancers","route":"/roadmaps/early-detection-roadmap/"},{"id":"cure-paths","kind":"roadmap","name":"Paths to cures: interception, eradication, control","route":"/roadmaps/cure-paths/"}],"pairing":[{"id":"ctdna-mrd-to-adjuvant","kind":"pairing","name":"ctDNA MRD → adjuvant therapy decision","route":"/pairings/ctdna-mrd-to-adjuvant/"}],"idea":[{"id":"idea-prev-mced-positive-resolution-pathway","kind":"idea","name":"A 28-day national pathway for people with a positive multi-cancer blood test","route":"/ideas/idea-prev-mced-positive-resolution-pathway/"},{"id":"idea-tr2-ctdna-reference-plasma","kind":"idea","name":"Certified reference samples to benchmark every tumour-DNA blood test","route":"/ideas/idea-tr2-ctdna-reference-plasma/"},{"id":"idea-ctdna-guided-adjuvant-crc","kind":"idea","name":"ctDNA-guided adjuvant therapy as the default in stage II-III colon cancer","route":"/ideas/idea-ctdna-guided-adjuvant-crc/"},{"id":"idea-tr2-ctdna-mrd-qualification","kind":"idea","name":"Formally qualify tumour-DNA blood tests as a surrogate endpoint for adjuvant trials","route":"/ideas/idea-tr2-ctdna-mrd-qualification/"},{"id":"idea-bio2-mrd-coverage-with-evidence","kind":"idea","name":"Pay for residual disease tests only inside a trial or registry","route":"/ideas/idea-bio2-mrd-coverage-with-evidence/"},{"id":"idea-bio2-whole-genome-mrd-depth","kind":"idea","name":"Push residual disease detection a hundredfold deeper with whole-genome methods","route":"/ideas/idea-bio2-whole-genome-mrd-depth/"},{"id":"idea-bio2-mrd-reference-standards","kind":"idea","name":"Reference materials and open proficiency testing for residual disease tests","route":"/ideas/idea-bio2-mrd-reference-standards/"},{"id":"idea-bio1-methylation-clone-tracking","kind":"idea","name":"Track clones in blood with methylation patterns instead of mutations","route":"/ideas/idea-bio1-methylation-clone-tracking/"}],"section":[{"id":"diagnostics","kind":"section","name":"Diagnostics & Biomarkers","route":"/fronts/diagnostics/"},{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"technology":[{"id":"cfdna-methylation-testing","kind":"technology","name":"Cell-free DNA methylation tests","route":"/technologies/cfdna-methylation-testing/"},{"id":"fragmentomics","kind":"technology","name":"cfDNA fragmentomics","route":"/technologies/fragmentomics/"},{"id":"companion-diagnostic","kind":"technology","name":"Companion diagnostics","route":"/technologies/companion-diagnostic/"},{"id":"continuous-ctdna-monitoring","kind":"technology","name":"Continuous and near-continuous ctDNA monitoring","route":"/technologies/continuous-ctdna-monitoring/"},{"id":"methylation-profiling","kind":"technology","name":"DNA methylation profiling","route":"/technologies/methylation-profiling/"},{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"mrd-testing","kind":"technology","name":"MRD / molecular residual disease testing","route":"/technologies/mrd-testing/"},{"id":"mced","kind":"technology","name":"Multi-cancer early detection (MCED)","route":"/technologies/mced/"},{"id":"mrd-kinetics-models","kind":"technology","name":"Residual disease kinetics (BCR-ABL halving and ctDNA slopes)","route":"/technologies/mrd-kinetics-models/"}],"drug":[{"id":"atezolizumab","kind":"drug","name":"Atezolizumab","route":"/drugs/atezolizumab/"},{"id":"cobas-egfr-mutation-test","kind":"drug","name":"cobas EGFR Mutation Test v2","route":"/drugs/cobas-egfr-mutation-test/"},{"id":"erlotinib","kind":"drug","name":"Erlotinib","route":"/drugs/erlotinib/"},{"id":"foundationone-cdx","kind":"drug","name":"FoundationOne CDx / Liquid CDx","route":"/drugs/foundationone-cdx/"},{"id":"galleri","kind":"drug","name":"Galleri","route":"/drugs/galleri/"},{"id":"guardant-reveal","kind":"drug","name":"Guardant Reveal","route":"/drugs/guardant-reveal/"},{"id":"guardant360-cdx","kind":"drug","name":"Guardant360 CDx","route":"/drugs/guardant360-cdx/"},{"id":"osimertinib","kind":"drug","name":"Osimertinib","route":"/drugs/osimertinib/"},{"id":"radar-mrd","kind":"drug","name":"RaDaR","route":"/drugs/radar-mrd/"},{"id":"shield","kind":"drug","name":"Shield","route":"/drugs/shield/"},{"id":"signatera","kind":"drug","name":"Signatera","route":"/drugs/signatera/"},{"id":"trifluridine-tipiracil","kind":"drug","name":"Trifluridine/tipiracil","route":"/drugs/trifluridine-tipiracil/"}],"company":[{"id":"delfi-diagnostics","kind":"company","name":"DELFI Diagnostics","route":"/companies/delfi-diagnostics/"},{"id":"exact-sciences","kind":"company","name":"Exact Sciences 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