Liquid Biopsy Newsletter
February 2026, Vol. 1
Dear Readers, dear Colleagues,
Welcome to our LIQOMICS Liquid Biopsy Newsletter!
Liquid biopsy – the analysis of tumor DNA from a blood sample – is transforming cancer diagnostics, and scientific evidence is growing rapidly. But how quickly will this innovation reach standard care?
In this Liquid Biopsy Newsletter, we look to the American NCCN Guidelines – evidence-based treatment recommendations from 33 leading US cancer centers, considered the global gold standard.
The news: With Version 1.2025, ctDNA-MRD testing – the detection of minimal amounts of circulating tumor DNA in blood – was included for the first time as an official recommendation for patients with diffuse large B-cell lymphoma (DLBCL).
For patients, this means that a blood sample can clarify whether an abnormal PET scan indicates cancer cells or is a false alarm – without biopsy, without unnecessary therapies.
Physicians receive evidence-based decision support through ctDNA-MRD testing for PET-positive findings, which can have a very high false-positive rate.
As European pioneers in the detection of ctDNA in lymphomas and solid tumors, we developed LymphoVista, a test that allows MRD determinations according to NCCN Guidelines and is already being used by oncologists.
For us, this means not only diagnostic innovation – but also the commitment to drive the integration of liquid biopsy into routine care through active participation in research projects and industry initiatives.
Your opinion is important to us: Do you have suggestions or questions? What topics are important to you? Write to us: newsletter@liqomics.com
I wish you an insightful read!
Sven Borchmann MD, PHD, LIQOMICS founder and Managing Director
New Diagnostic Recommendations in the USA for Lymphoma Treatment
Sven Borchmann MD, PHD, LIQOMICS founder and Managing Director, explains the background and relevance of this updated diagnostic recommendation for you as healthcare providers and patients:
The NCCN Guidelines (National Comprehensive Cancer Network Guidelines) are evidence-based treatment and diagnostic recommendations. The NCCN Guidelines are continuously updated by expert panels from 33 leading US cancer centers. They summarize the current state of science and are considered the global gold standard in oncology – serving as guidance for optimal treatment.
With Version 1.2025 of the NCCN Clinical Practice Guidelines (December 2024), an important milestone has been reached: ctDNA-MRD testing – the detection of minimal amounts of circulating tumor DNA in blood – has been included for the first time as an official recommendation for patients with diffuse large B-cell lymphoma (DLBCL, the most common form of aggressive lymphoma).
What does this mean in practice?
For clinical practice:
- ctDNA-MRD testing is recommended as an alternative to biopsy for PET-positive findings after first-line therapy
- Patients with PET-positive but ctDNA-negative results can follow the PET-negative surveillance pathway
- This avoids unnecessary invasive procedures and treatment extensions
For patients: A simple blood draw can clarify whether an abnormal PET scan actually indicates remaining cancer cells or is a false alarm – without requiring a tissue biopsy.
The Problem of False-Positive Rates in PET Scans
Previously, the PET scan was considered the method of choice for diagnostic monitoring during the treatment course of DLBCL patients. A PET scan (Positron Emission Tomography) is an imaging procedure that visualizes metabolically active areas in the body. Cancer cells typically consume large amounts of energy and therefore appear as "bright spots" in the image. However, inflammation, infections, or scarring after therapy can look similar.
PET scans at the end of therapy frequently show abnormal findings that do not represent actual tumor remnants – these are called "false-positive" results. Previously, this often led to burdensome biopsies (tissue removal with a needle) or unnecessary continued treatment – an enormous psychological and physical burden for patients. ctDNA testing now offers a gentle and precise clarification of these cases through a simple blood sample.
The Study Data in Detail
The NCCN recommendation is based on clinical studies and meta-analyses in which DLBCL patients were examined with both PET scans and ctDNA-MRD tests after completing first-line therapy (R-CHOP or Pola-R-CHP). The key question: How well can the ctDNA test predict which patients will actually experience relapse?
| Parameter | Result | What does this mean? |
|---|---|---|
| 36-Months-PFS* (MRD-negativ) | 85% | Of 100 patients without detectable tumor DNA in blood, 85 remain relapse-free for three years |
| 36-Months-PFS* (MRD-positiv) | 15% | Of 100 patients with detectable tumor DNA, 85 experience relapse within three years |
| Hazard Ratio for Progression | 13,69 | MRD-positive patients have an almost 14-fold higher risk of relapse than MRD-negative patients |
| Specificty in PET-negative | 90,8% | When the PET scan is normal and the ctDNA test is also negative, there is over 90% probability that truly no residual disease exists |
*PFS = Progression-Free Survival (time without disease progression)
The Decisive Finding: PET-positive, ctDNA-negative
This is the core of the NCCN recommendation: Studies show that patients with PET-positive but ctDNA-negative findings have outcomes as good as patients with completely negative PET scans.
What does this mean concretely?
- The ctDNA test can confirm in PET-positive patients that the abnormal scan is a false alarm
- These patients require no biopsy and no therapy escalation
- They can confidently follow the PET-negative surveillance pathway
Clinical consequence: For PET-positive findings after first-line therapy, the ctDNA-MRD status determines whether aggressive intervention is necessary or whether the patient can transition to surveillance without further burden.
Sources:
- NCCN Clinical Practice Guidelines B-Cell Lymphomas, Version 1.2025 (December 2024)
- Wang S et al. J Clin Oncol. 2025;43(16_suppl):7000
- ctDNA Meta-Analyse. npj Precision Oncology. 2025 (53 studies, >3.700 patients)
LymphoVista: Precise MRD Detection for Your Patients
Our LymphoVista test was specifically developed for this clinical question. As a highly sensitive test, it supports physicians in distinguishing between true residual tumor and false-positive PET findings – giving patients and physicians confidence through non-invasive diagnostics.
The NCCN recommendation confirms what we already experience in clinical practice: ctDNA-MRD testing is fundamentally changing DLBCL surveillance – for the benefit of patients.
More Information: www.liqomics.com/lymphovista
Personal consultation: Contact our team contact@liqomics.com
