In April 2025, Thermo Fisher ScientificTM hosted a webinar designed to explore the latest headlines in liquid biopsy news and provide a comprehensive update for the precision oncology community.
From actionable plans to improve access to testing, to recent changes in reimbursement and coding in the United States, and the need for decentralized liquid biopsy testing – we bring you the essential highlights.
Liquid Biopsies for Precision Oncology
Simon Heeke, Head of the Liquid Biopsy Translational Working Group at MD Anderson Cancer CenterTM in Houston, Texas, began by guiding us through the current landscape for liquid biopsies in precision oncology.
Heeke detailed how circulating nucleic acids act as biomarkers in blood biopsies, before going on to explain how pathologists use RNA-based fusion detection to identify multiple fusions for cancer classification.
Of course, liquid biopsies go beyond blood. Heeke illustrated how cerebrospinal fluid (CSF) liquid biopsy can be used to identify oncogenic drivers in lung and breast cancer. Another example, he said, is fine needle aspiration (FNA) supernatant, which allows rapid molecular profiling and demonstrates good correlation to cytology analysis.
On a heat map of the US, Heeke showed how access to oncology care differs across the various states – with a scarcity of care apparent throughout Middle America. To expand access, he argued, more liquid biopsy centers are urgently required. While tissue samples require specialist expertise and equipment to collect and process, liquid biopsies are easily collected in the community, with minimal training.
Liquid biopsies, Heeke continued, can offer clinicians a “minimally invasive approach to obtaining real-time insights into tumor biology,” allowing for rapid patient turnaround times, helping to better guide treatment and therapy decisions, and potentially expanding access to care due to the ease with which they can be sampled.
Creating Equitable and Widespread Implementation of Liquid Biopsy for Cancer Care
Lauren Leiman, Executive Director of the Blood Profiling Atlas in Cancer (BLOODPAC) Consortium, reported on how the organization is helping to break down implementation barriers for liquid biopsy testing.
BLOODPAC brings together global collaborators from academia, government, diagnostics developers, pharmaceuticals, private payers, and not-for-profit organizations. For years, its working groups have been generating evidence in support of introducing liquid biopsy into routine clinical practice.
The Accessibility Working Group has been looking into the barriers to adoption of liquid biopsy testing. According to their findings, levels of skepticism are still high. A lack of awareness or education, uncertainty over the performance of liquid biopsy tests, and concerns about the costs all stand in the way of implementation.
With its paper, “Recommendations for the Equitable and Widespread Implementation of Liquid Biopsy for Cancer Care,” the Accessibility Working Group now hopes to effect change (1). The article lays out specific, practical actions to help ensure equitable access to all patients.
In summary, Leiman emphasized three important messages:
Significant barriers still exist to the adoption of liquid biopsy tests across the US healthcare system – particularly for underserved communities.
Liquid biopsy tests have the potential to influence access to treatments and improve outcomes for cancer patients.
A roadmap for action in helping ensure these innovations benefit all communities is clearly laid out in BLOODPAC’s accessibility paper.
Reimbursement for Liquid Biopsy in the US
Charles Mathews, Partner at ClearView Healthcare PartnersTM, reported on the recently updated reimbursement model for comprehensive genomic profiling (CGP) via ctDNA testing.
From the payers’ perspective, tissue-based CGP is still widely used for cancer diagnostics. But what happens when tissue biopsy is not feasible or there is insufficient tissue to test?
There is good news: In 2025, a series of new Current Procedural Terminology (CPT) codes were created to describe liquid biopsy tests for solid tumor testing. Codes for genomic sequence analysis, cell-free nucleic acid (e.g., plasma), and interrogation for sequence variants – DNA analysis or combined DNA and RNA analysis, CNV, and rearrangements – are now available. Additional codes include microsatellite instability and tumor mutational burden testing, reported Mathews.
However, with so many limitations on reimbursement for liquid biopsy, is there any incentive for manufacturers to develop and commercialize them? Mathews cited some emerging trends that might improve the situation.
First, the body of evidence supporting the clinical utility of ctDNA approaches continues to grow. With that, test regulation and quality control work, carefully balanced with the need for laboratory developed tests, is helping to improve confidence in test performance. Furthermore, the increasing number and significance of technological innovations that rely on liquid biopsy testing cannot be ignored. Minimal residual disease assessment and HER2 serum extracellular domain testing are two examples seeing rapid growth in uptake.
The tide seems to be turning for liquid biopsy adoption, said Mathews. With more applications now emerging, more reimbursements will – necessarily – open up.
Precision Medicine and Liquid Biopsy: The Patient Perspective
In the final presentation, Nikki Martin, Senior Director of LUNGevity FoundationTM Precision Medicine Initiatives, advocated for a more engaged approach to patient care in precision medicine and liquid biopsy. Providing clear explanations, using patient-friendly language, and involving patients in the testing process, is the key to their empowerment, she argued.
It is also crucial to understand the factors that prevent individuals from having biomarker testing, said Martin. LUNGevity’s work has revealed a wide variety of potential barriers – including English as a second language, socioeconomic disadvantage, and a lower level of education.
Using data taken from LUNGevity patient focus groups, Martin also examined what patients themselves reported about their experiences with liquid biopsy. Interestingly, while the groups did appreciate the less invasive nature and potential for real-time disease monitoring, many still have concerns over the accuracy and limitations of liquid biopsy tests. There was some documented confusion as to what liquid biopsy actually entails and how it differs from other tests, such as minimal residual disease assessment.
Words are important, Martin continued, emphasizing that unclear terminology and technical jargon does nothing but present communication barriers for patients. Patients’ understanding of their cancer can lead to them pursuing better, more efficient treatment options.
To this end, LUNGevity has developed – with patient input – a cancer decision tree to empower patients to better navigate communicating about biomarker results with their healthcare providers. You can find it here: https://bit.ly/4jTasWh.
The Future Standard of Care for Cancer Diagnostics
As this exploration into the transformative potential of liquid biopsy-based precision oncology concluded, it is clear liquid biopsy holds the key to revolutionizing cancer diagnostics and treatment. The insights shared by thought leaders underscore the urgency and promise of democratizing access to these potentially life-saving technologies. Now is the time for laboratories across the United States to embrace liquid biopsy, breaking down barriers and expanding access to help ensure that all patients, regardless of their location or socioeconomic status, can benefit from precision oncology. Liquid biopsy may one day be a standard of care that transforms lives and brings us closer to a future where cancer is a manageable condition for all.
Thermo Fisher Scientific and its affiliates are not endorsing, recommending, or promoting any use or application of Thermo Fisher Scientific products presented by third parties in this presentation. Information and materials presented or provided by third parties are provided as-is and without warranty of any kind from Thermo Fisher Scientific, including regarding intellectual property rights and reported results. Parties presenting images, text and material represent they have the rights to do so.; Contributors received an honorarium from Thermo Fisher Scientific.
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References
- P G Febbo et al., “Recommendations for the Equitable and Widespread Implementation of Liquid Biopsy for Cancer Care,” JCO Precision Oncology, 8 (2024). PMID. 38166232.
