ESMO Congress 2026

Within the liquid biopsy class, the circulating tumor cell (CTC)-based technology line is supported by several published studies. The LiquidBiopsy platform performs positive selection and quantitative isolation of CTCs via high-throughput sheath-flow microfluidics, yielding cells suitable for molecular analyses such as mutation detection ^[1]. In breast cancer, HER2+ CTCs were defined as HER2 immunofluorescence intensity ≥3.5 times CD45, with 100% sensitivity and 99.9% specificity ^[2]. A urothelial cancer pilot simultaneously assessed CTCs and cfDNA, detecting mutations in 13/16 (81.3%) patients with a median of 18, and recovered more CTCs than previously reported with the CellSearch platform ^[3]. In advanced lung cancer, 71.2% (37/52) of patients had detectable CTCs at baseline and 50.0% (26/52) were CTC PD-L1+, with ORR of 84.2% vs 36.8%, median PFS of 16 vs 4 months (HR=0.28), and superior OS (HR=0.19) ^[5].

The meeting itself involved two presentations. The main thread was Christian Rolfo (Ohio State) on how liquid biopsy can make early-phase drug development faster, better and more efficient: 8 applications in total, from patient selection through to early signals of activity and resistance, with his institution's account announcing his Friday talk. Separately, Herbert H. Loong in Madrid (#ESMO2026) emphasized that the future of precision oncology depends on three key elements—Precision, Speed, and Access: multi-omic liquid biopsy approaches can complement tissue testing, support MRD detection, monitor treatment response, and potentially make precision oncology more accessible and sustainable—precision oncology is not just about identifying the right treatment, but delivering it at the right time to more patients.

Relative to existing knowledge, each talk pushes a step further. Prior evidence consists largely of single-tumor, single-biomarker association analyses ^[2][3][5]; Rolfo extends this into 8 application points across the early-phase development workflow, from enrollment selection to early activity and resistance signals, while Loong brings MRD detection, treatment response monitoring, and accessibility and sustainability into a single framework, shifting the question from 'can we measure it' to 'can the right treatment reach more patients at the right time.'

Limitations should also be noted: the posts are relayed summaries of talks, and the specific data, trials, and platform details of both presentations were not disclosed; the published evidence itself is mostly small-sample exploratory work—the urothelial cancer study enrolled only 16 patients ^[3], liquid biopsy has not yet entered clinical practice in head and neck cancer, and cfDNA concentration showed no significant differences by sex or general status ^[6]—so the cutoffs and clinical utility await validation at larger scale.