From Early Screening to Treatment: Liquid Biopsy Begins to Enter Clinical Pathways

Liquid biopsy is a type of test that obtains tumor information through body fluid samples such as blood. Common targets for testing include circulating tumor DNA (ctDNA), circulating tumor cells (CTC), and exosomes. Compared to traditional biopsies that require tissue extraction, it is less invasive and can be repeated, making it suitable for multiple sampling at different time points to observe tumor changes.

The application of traditional liquid biopsy is to use ctDNA or CTC for early cancer screening and testing, providing supplementary information when tissue samples are insufficient or cannot be obtained.

However, in the past two years, liquid biopsy companies have moved beyond merely delivering test reports to hospitals or patients, and have begun to push test results into subsequent treatment stages, impacting the entire process from early screening to treatment.

From Reporting to Implementation: Liquid Biopsy Competition Enters a New Dimension

In the real world, much of the value does not occur at the moment of 'report generation' but happens after the report:

1. Whether patients are correctly stratified (targets/heterogeneity/dynamic changes)

2. Does the doctor have tools to convert the stratification results into next steps (medication, dressing change, trial)?

3. Can the institution accumulate reusable structured data (long-term follow-up, efficacy correlation, resistance mechanisms)?

So the competitive dimensions of liquid biopsy companies are expanding:

They are no longer just doing IVD, but are connecting testing, data, and clinical processes, approaching platform-type infrastructure.

This is also the common trend among all liquid biopsy companies at present:

The division of labor is becoming increasingly clear.

• Testing companies are responsible for detecting tumor information and standardizing and scaling the data.

• AI platforms are better at organizing complex trial information, inclusion and exclusion criteria, lines of treatment, and other factors, helping doctors quickly screen.

• Pharmaceutical companies and trial systems provide real, accessible trial resources and handle enrollment.

The focus of industry competition is beginning to expand.

It's not just about who can detect more targets, but about who can more smoothly integrate the detected results into the subsequent processes, including trial matching, doctor usage, and patient follow-up.

From Testing Services to Precision Medicine

When test results can reliably inform treatment decisions and the execution of clinical trials, testing companies will occupy a more upstream position in the industry chain, also closer to the role of platform-based infrastructure.

The Watershed for Liquid Biopsy Companies: Capacity or Clinical Value

As the industry moves from early screening and detection to treatment decision-making and clinical trial execution, liquid biopsy companies will be reclassified.

The two common positions in the past were:

Equipment company: selling instruments to hospitals or laboratories, mainly delivering hardware and production capacity

Problem points:

The equipment can address efficiency, throughput, and operational processes, but what the medical system truly cares about is whether the results can be clinically used, whether they can influence decision-making, and whether they can be reliably reproduced across different hospitals.

If, after the equipment is delivered, the produced data is difficult to standardize or cannot smoothly integrate into the physicians' workflow, then the value brought by the equipment will be limited to the laboratory level and will be difficult to scale continuously.

Testing company: send the sample for testing, produce a report, charge per order

Problem points:

Competition easily turns into comparing panels, sensitivity, price, and turnaround time.

But in clinical practice, it's impossible to know what to do next based on a report that only tells me what variants are present.

If the results cannot consistently guide drug selection, relapse monitoring strategies, medication switch points, or clinical trial opportunities, then the value of the report will be reduced to the informational level, and both reimbursement and clinical adoption will encounter bottlenecks.

Platform-based liquid biopsy: turning detection capability into a clinical pathway