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An ultra-sensitive blood test after surgery that detects leftover cancer months before a scan would.
Tumour-informed assays (Signatera, Oncodetect, RaDaR) or tumour-naive assays (Guardant Reveal) detect ctDNA after curative treatment. ctDNA positivity predicts recurrence with high specificity. Trials (DYNAMIC, CIRCULATE, IMvigor011 in bladder cancer, positive in 2025-26 leading to atezolizumab approval in ctDNA+ MIBC) show it can guide adjuvant therapy. Standard in haematologic malignancies via flow cytometry and NGS (clonoSEQ).
Patient-specific variant panel designed from tumour sequencing, tracked at very high depth in plasma.
Nothing in the corpus depends on this yet.
Dependencies are what this technology cannot be delivered without: manufacturing steps, instruments, software, upstream methods. See its full chain on the map.
A PD-L1 blocker used in lung, liver, and bladder cancer. In 2026 it became the first drug approved based on a blood test showing leftover cancer after bladder surgery.
A DNA test that counts leftover leukaemia, myeloma or lymphoma cells down to one in a million, used to decide whether treatment has really worked.
A ready-made vaccine against the seven commonest KRAS mutations, given after pancreatic cancer surgery. Its phase 2 missed the main goal in 2026 but showed signs of activity.
A blood test for leftover cancer after surgery that needs no tumour sample, so results come faster than tumour-informed tests.
Exact Sciences' entry into the leftover-cancer blood test market, launched in 2025 for bowel cancer follow-up.
NeoGenomics' personalised blood test for tiny amounts of leftover cancer, tracking up to 48 mutations from the patient's own tumour.
Signatera is Natera's tumour-informed blood test that tracks 16 mutations from each patient's own tumour to detect residual or returning cancer after surgery. Medicare covers it in colorectal, breast, bladder, lung and ovarian cancer and for immunotherapy monitoring, and in 2026 it selected the bladder cancer patients for the first approval based on circulating tumour DNA.
Residual-disease testing may not need the tumour to be sequenced first, which would remove the slowest step of tumour-informed assays; the comparison with tumour-informed results in the same patients is the evidence that matters.
Together with the JCO Precision Oncology cohort this makes residual disease testing in biliary cancer prognostic to the same degree as in colon cancer. Nobody has yet shown that acting on it helps; that is the trial gap the ideas on this page name.
CEPHEUS extends the quadruplet standard to patients who are not going to transplant, closing the gap between transplant-eligible and ineligible populations. It is also one of the first phase 3 trials to be designed around MRD-negativity as the primary endpoint, which could shorten future myeloma trials by years. Frailer patients still need dose-adapted approaches.
Very wide confidence intervals from a small cohort, but the direction matches the larger 2026 analysis. Gallbladder cancer recurs early and distantly after re-resection, which is exactly the setting where a residual disease test could pick who gets more than capecitabine.
After bladder removal, a blood test can now tell who needs immunotherapy and who can safely be spared it. This is the model for MRD-guided adjuvant therapy across cancers: treat the blood-positive, watch the blood-negative.
E1910 changed the standard of care for adult B-ALL: immunotherapy is now part of front-line consolidation even for patients with no detectable leukaemia, because MRD-negative by flow cytometry does not mean cured. It also demonstrated that a T-cell engager can improve overall survival in a curative setting. Chemotherapy-light or chemotherapy-free regimens built on blinatumomab and inotuzumab are the next step.
PERSEUS, with the earlier GRIFFIN and CASSIOPEIA trials, made a four-drug daratumumab quadruplet the standard for fit patients heading to transplant. It also introduced MRD-directed stopping of the antibody, a step towards treatment that is deep but not indefinite. Whether transplant itself remains necessary on top of a quadruplet is now the open question.
ctDNA and RCB measure different things and both should stratify post-neoadjuvant TNBC trials; an RCB-II patient with negative ctDNA has an 87% three-year event-free survival.
Query for this technology: (TITLE:"minimal residual disease" OR ABSTRACT:"minimal residual disease" OR TITLE:"molecular residual disease" OR ABSTRACT:"molecular residual disease" OR TITLE:"ctDNA MRD" OR ABSTRACT:"ctDNA MRD") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about MRD / molecular residual disease testing, not a curated reading list.
Shares ESMO recommendations on the use of circulating tumour DNA assays for patients with cancer: a report from the ESMO Precision Medicine Working Group, Adela, Bank yearly blood from cancer survivors so future tests can be validated, FDA laboratory-developed test (LDT) rule and the tag precision.
Shares BillionToOne, NeoGenomics, Personalis (Tempus), Inivata and the tag precision.
Shares Early gastric cancer, Early cervical cancer and fertility-sparing surgery, Locally advanced cervical cancer, Paths to cures: interception, eradication, control and the tag precision.
Shares Early cervical cancer and fertility-sparing surgery, POLE-ultramutated endometrial cancer, High-risk early HR-positive breast cancer, Early HER2-positive breast cancer and the tag precision.
Shares Maximilian Diehn, A test to tell true oligometastatic disease from hidden widespread spread, When the blood test is positive, hunt for the lesion with sensitive imaging, Hallmark: activating invasion and metastasis and the tag precision.
Shares PRODIGE 90 - (FFCD 2204) Neoadjuvant Dostarlimab with Short Course Radiotherapy in a Watch-and-wait Strategy for Microsatellite Unstable or Mismatch Repair-defi, Organ preservation as the default after complete response in oesophageal cancer, Children's Cancer Hospital Egypt 57357, Personalized Escalation of Consolidation Treatment Following Chemoradiotherapy and Immunotherapy in Stage III NSCLC in Stage III NSCLC and the tag precision.
Shares Sylvester Comprehensive Cancer Center, University of Miami, Cancer Center Clínica Universidad de Navarra / CIMA, National Cancer Center Hospital East, Locally advanced cervical cancer and the tag precision.
Shares Diagnostics roadmap: stains → gene panels → blood tests that decide treatment, Endometrial cancer, Gastric & gastro-oesophageal junction cancer, Triple-negative breast cancer (TNBC) and the tag precision.