Continuous and near-continuous ctDNA monitoring
Instead of testing blood every three months, sampling constantly, so a relapse is caught the week it starts.
MRD testing already detects relapse months before imaging, but sampling is episodic. Work on implantable and wearable sampling, microneedle interstitial-fluid collection, and at-home dried blood spots aims to shorten the interval, while urine and saliva ctDNA reduce the burden of venepuncture. Nothing in this class was validated for clinical use by 2026, and the question of what to do with an earlier signal is still open.
How it works
Frequent low-volume sampling of blood or interstitial fluid, with error-suppressed sequencing or targeted PCR, turns a periodic test into a trend line.
- Earlier detection of relapse and of resistance
- A trend beats a single value for treatment decisions
- Fewer clinic visits
- No validated device
- Assay sensitivity limited by cfDNA quantity in small samples
- Lead time without a proven intervention causes harm as well as good
Latest papers
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