Novel Blood Test Detects Lung Cancer Traces Long Before Scans

Despite advances in early-stage lung cancer treatment, a significant number of patients experience disease recurrence after surgery or initial therapy. A novel study has now demonstrated that a blood test (liquid biopsy) can reliably detect lingering lung cancer traces even in the earliest clinical stages, long before a tumor is large enough to show up on a scan. This real-time genetic monitoring detailed in an articleopens in new tab/window appearing in The Journal of Molecular Diagnosticsopens in new tab/window, published by Elsevier, accurately predicts relapse risk, opening a critical window for timely, personalized therapeutic interventions.

Non–small-cell lung cancer (NSCLC) is the most common type of lung cancer and remains the major cause of cancer-related death. Small tumors in patients with early-stage NSCLC (I to II) are usually surgically removed, and survival rates are reasonably high. However, even in stage I, disease recurrence rates range between 5% and 19%, and imaging follow-up remains standard of care.

“As oncology shifts towards personalized risk-adapted care, liquid biopsies are emerging as a critical tool to bridge the gap between treatment completion and clinical recurrence,” explains lead investigator Matija Snuderl, MD, Department of Pathology, NYU Langone Health and Grossman School of Medicine, and Laura and Isaac Perlmutter Cancer Center, New York, NY. “In our study, we monitored patients with lung cancer across treatment stages using serial blood draws to track circulating tumor DNA (ctDNA) levels. By analyzing tumor-specific signatures of ctDNA shed by tumor cells into the bloodstream, we evaluated how effectively liquid biopsy predicts relapse compared to standard imaging.”

The most significant finding was that a positive test result for tumor DNA served as a highly sensitive biomarker for minimal residual disease, detecting microscopic recurrence months before scans showed physical tumors, while a clear (negative) test strongly correlated with sustained remission.

“As a surgeon, I follow my patients very closely, and I want to know as soon as possible if the cancer has come back. Unfortunately, even the earliest stage patients risk recurrence,” notes co-lead investigator Harvey I. Pass, MD, Department of Cardiothoracic Surgery, NYU Langone Health, New York, NY. “Our study’s findings highlight just how sensitive and specific liquid biopsy can be when integrated into routine post-treatment monitoring, even in the earliest stages of lung cancer. This is of critical importance for deciding on post-operative treatments.”

Dr. Snuderl adds, “Minimal residual disease testing via liquid biopsy represents a fundamental shift in post-operative care. It gives pathologists a powerful tool to diagnose disease before it appears on imaging and equips clinicians with actionable insights to personalize surveillance and intervention strategies for every individual patient."

The study highlights the implications of these blood tests for every stage of the patient journey:

• Clinicians can identify high- or low-risk patients far earlier.

• Test results help guide targeted treatment for patients with detectable residual disease, while potentially sparing those with clear test results from the burden of unnecessary overtreatment and toxicity.

• These liquid biopsies offer actionable clarity, reducing the anxiety of waiting between periodic imaging scans by replacing uncertainty with clear biological data.

• Early detection of relapse allows treatment to restart when the disease burden is extremely low, substantially improving long-term outcomes and survival prognosis.

The WGS liquid biopsy technology used in this study was developed by co-investigator Asaf Zviran, PhD, C2i Genomics Inc., New York, NY, who concludes, “The true promise of residual disease monitoring has always been to identify patients at high risk of recurrence early enough to enable curative intervention—before the cancer has an opportunity to spread, evolve, and diversify.”

Notes for editors

The article is “Predicting Recurrence of Stage IA Lung Adenocarcinoma Using Circulating Tumor Cell—Free DNA Whole-Genome Mutational Signatures,” by Matija Snuderl, James Smadbeck, Reid Wilkins, Kenneth Tokoro, Ryan Ptashkin, Isabella Pizzillo, Alejandro Vargas, Andre Moreira, Danielle Afterman, Tomer Lauterman, Maja Kuzman, Santiago Gonzalez, Dunja Glavas, Dillon Maloney, Jurica Levatic, Samuel Phillips, Sunil Deochand, Michael Yahalom, Iman Tavassoly, Zohar Donenhirsh, Eric White, Ravi Kandasamy, Ury Alon, Paz Polak, Boris Oklander, Asaf Zviran, and Harvey I. Pass (https://doi.org/10.1016/j.jmoldx.2026.07.003opens in new tab/window). The article appears online ahead of volume 28, issue 11 (November 2026) of The Journal of Molecular Diagnostics, published by Elsevier.

The article is openly available for 90 days at https://www.jmdjournal.org/article/S1525-1578(26)00127-3/fulltextopens in new tab/window.

Full text of the article is also available to credentialed journalists upon request. Contact Eileen Leahy at +1 732 406 1313 or [email protected]opens in new tab/window to request a PDF of the article or additional information. To reach the study’s authors contact Matija Snuderl, MD, at [email protected]opens in new tab/window.

About The Journal of Molecular Diagnostics

The Journal of Molecular Diagnosticsopens in new tab/window, the official publication of the Association for Molecular Pathology, co-owned by the American Society for Investigative Pathology, and published by Elsevier, seeks to publish high quality original papers on scientific advances in the translation and validation of molecular discoveries in medicine into the clinical diagnostic setting, and the description and application of technological advances in the field of molecular diagnostic medicine. The editors welcome review articles that contain: novel discoveries or clinicopathologic correlations, including studies in oncology, infectious diseases, inherited diseases, predisposition to disease, or the description of polymorphisms linked to disease states or normal variations; the application of diagnostic methodologies in clinical trials; or the development of new or improved molecular methods for diagnosis or monitoring of disease or disease predisposition. www.jmdjournal.orgopens in new tab/window

About Elsevier

Elsevier is a global leader in advanced information and decision support. For over a century, we have been helping advance science and healthcare to advance human progress. We support academic and corporate research communities, doctors, nurses, future healthcare professionals, and educators across 170 countries in their vital work. We help impact makers achieve better outcomes with research and clinical-grade solutions built on the world’s leading evidence-based scientific and medical content, precision AI, and expert human assessment. We champion inclusion and sustainability, working with the communities that we serve. The Elsevier Foundationopens in new tab/window supports research and health partnerships around the world.

Elsevier is part of RELXopens in new tab/window, a global provider of information-based analytics and decision tools for professional and business customers. For more information, visit www.elsevier.com and follow us on social media @elsevierconnect.