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New liquid biopsy tests advance multi-cancer early detection

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ROME, July 16 — The shift is happening in plain sight. Cancer detection is moving from single-organ biopsies to a single blood draw, and the technology driving that change is liquid biopsy. At ADLM 2026, the annual meeting of the Association for Diagnostics & Laboratory Medicine, advances in cancer screening and biomarkers are taking centre stage, with liquid biopsy technologies leading the conversation.

The concept isn’t new. Researchers including Dennis Lo first demonstrated the detection of circulating tumor DNA, or ctDNA, in blood in 1994.

That was the spark. It took more than two decades for the first FDA-approved liquid biopsy test to arrive: the cobas EGFR Mutation Test v2 in 2016, specifically for non-small cell lung cancer. The pace has accelerated sharply since.

What’s changing now is the ambition. Multi-cancer early detection, or MCED, tests aim to screen for many cancer types from a single blood sample.

The Galleri test, developed by Grail, analyses methylation patterns of ctDNA to detect over 50 cancer types. That’s a leap from the single-cancer approach. The trend underneath is about scale: instead of hunting one tumour at a time, researchers are looking for the molecular signatures of many cancers simultaneously.

The biggest real-world test of this approach is the NHS-Galleri trial in the United Kingdom, launched in 2021. It is enrolling 140,000 participants to evaluate whether MCED screening can work at population scale. Results from that trial will shape the regulatory and clinical landscape for years to come.

Liquid biopsy sits alongside older biomarker tools that have been in clinical use for decades. Prostate-specific antigen, or PSA, for prostate cancer was first approved by the FDA in 1986.

CA-125 for ovarian cancer was discovered in 1981. These are established markers, but they test for one cancer at a time and have known limitations in specificity and sensitivity. Liquid biopsy, by contrast, offers a broader net.

The ADLM has published guidelines on the use of tumor markers, including the 2010 National Academy of Clinical Biochemistry guidelines. Those guidelines remain a reference point, but the field is moving fast enough that new data from trials like NHS-Galleri could prompt updates.

The technology is not yet routine. Cost, reimbursement, and the need for large validation studies remain hurdles. But the trajectory is clear: liquid biopsy is shifting cancer screening from reactive to proactive.

The question now is how quickly health systems can adopt it. Consult your doctor for medical advice.

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