Circulating tumor DNA in 2026: overview
Circulating tumor DNA is DNA shed by tumor cells and detectable in blood. Because it can reflect tumor mutations and other molecular features, ctDNA analysis can support cancer monitoring without repeatedly sampling tumor tissue. Its appeal is strongest where a blood test could reveal residual disease, changing treatment response or emerging resistance. But low ctDNA levels, variation between tumors and differences in assay design can make results difficult to detect and interpret. The field is therefore advancing both assay sensitivity and the evidence needed to use results in clinical decisions.
Recent work spans new assays and treatment-guidance studies. In August 2026, researchers introduced ALFAssay, a neural-network method for estimating ctDNA from shallow whole-genome sequencing, addressing challenges in tumors with few copy-number changes. In September 2026, Stanford University and Foresight Diagnostics filed a patent on ctDNA monitoring methods. In October 2026, BillionToOne reported high concordance for its Northstar Response tissue-free assay in an advanced-cancer study. Together, these developments point toward more flexible detection and closer integration of serial blood testing into treatment decisions, while questions of sensitivity, validation and study design remain central.
- 1MRD moves forward: Work on minimal residual disease grew 62.6% in the latest 12-month comparison, reinforcing its position as a major ctDNA application.
- 2Methods diversify: Tumor-informed sequencing, methylation profiling and fragmentomics offer complementary signals, as researchers seek to detect disease that mutation panels may miss.
- 3Evidence remains pivotal: Publication activity rose 18.7% while patent activity fell 59.6% in the latest 12-month comparison, underscoring the field’s strong research momentum and uneven IP activity.
Top organizations working on circulating tumor DNA
Ranked by Linknovate activity score · last 24 monthsThe activity score adds up the relevance of every patent, publication, grant and news item linking an organization to circulating tumor DNA. Showing 7 of 3,000 organizations.
| # | Organization | Approach | Signals (24 mo) | Momentum | Why it matters |
|---|---|---|---|---|---|
| 1 | 
University of Texas M. D. Anderson Cancer Center
Research · United States |
General | PUB 191 · NEWS 87 | +26% | Researchers study ctDNA for cancer monitoring, recurrence assessment and clinical-trial endpoints across tumor types, including adrenocortical carcinoma, lymphoma and breast cancer. |
| 2 | 
Natera
Corporate · United States |
Tumor-informed sequencing | PAT 13 · PUB 98 NEWS 80 |
+7% | Recently, Natera’s Signatera assay is being evaluated in a trial to guide de-escalation of adjuvant therapy in resectable gastric and gastroesophageal cancer. Its tumor-informed ctDNA tests also track treatment response and residual disease. |
| 3 | 
MayoClinic
Research · United States |
General | PUB 131 · NEWS 54 | +32% | Mayo Clinic researchers assess ctDNA’s clinical uses in cancer, including molecular residual disease, recurrence risk and treatment monitoring across gastrointestinal, endometrial and urothelial cancers. |
| 4 | 
Memorial Sloan Kettering Cancer Center
Research · United States |
General | PAT 2 · PUB 151 NEWS 18 |
+6% | Researchers investigate ctDNA for treatment-outcome prediction, recurrence surveillance and detection of targetable alterations, including in metastatic breast cancer and neuroblastoma. |
| 5 | 
Harvard University
Research · United States |
General | PAT 2 · PUB 143 NEWS 13 |
-5% | Researchers study ctDNA as a biomarker for cancer treatment response and risk assessment, including in breast cancer and cancer-associated venous thromboembolism. |
| 6 | 
Dana-Farber Cancer Institute
Research · United States |
Tumor-informed sequencing | PAT 5 · PUB 127 NEWS 42 |
-25% | Researchers evaluate ctDNA for minimal residual disease and treatment-response assessment, including an ultrasensitive assay study in breast cancer and surveillance research in Merkel cell carcinoma. |
| 7 | 
Guardant Health
Corporate · United States |
Methylation profiling | PAT 16 · PUB 68 NEWS 112 |
-11% | Recently, Guardant filed a patent for a methylation-based ctDNA assay linking tumor fraction with outcomes in non-small-cell lung cancer. Its liquid-biopsy portfolio also profiles tumor-derived genomic alterations. |
| 8 | ··Hidden organizationCompany | Approach | PAT 00 · PUB 00 GRANTS 0 · NEWS 00 | +00% | Available to registered users. |
| 9 | ··Hidden organizationCompany | Approach | PAT 00 · PUB 00 GRANTS 0 · NEWS 00 | +00% | Available to registered users. |
| 10 | ··Hidden organizationCompany | Approach | PAT 00 · PUB 00 GRANTS 0 · NEWS 00 | +00% | Available to registered users. |
Startups to watch and leading research centers
Startups to watch 30 total
GRAILUnited StatesGRAIL develops Galleri, a blood-based multicancer early-detection test that analyzes cancer-associated signals in cell-free DNA. Its focus is detecting multiple cancer types before symptoms appear.
Foresight DiagnosticsRecently, Foresight filed a patent on methods for monitoring ctDNA. Its work focuses on ultrasensitive, tumor-informed detection of molecular residual disease, including in lymphoma.
BillionToOne Inc.United StatesRecently, BillionToOne reported a study comparing its Northstar Response tissue-free liquid-biopsy assay with another test. Its research includes molecular counting to quantify methylated ctDNA for treatment-response monitoring.- ··Hidden startupCountryAvailable to registered users, with funding and founding year.
- ··Hidden startupCountryAvailable to registered users, with funding and founding year.
Leading research institutions 2,492 total
- University of Texas M. D. Anderson Cancer CenterUnited StatesResearchers study ctDNA for cancer monitoring, recurrence assessment and clinical-trial endpoints across tumor types, including adrenocortical carcinoma, lymphoma and breast cancer.
- Memorial Sloan Kettering Cancer CenterUnited StatesResearchers investigate ctDNA for treatment-outcome prediction, recurrence surveillance and detection of targetable alterations, including in metastatic breast cancer and neuroblastoma.
- Harvard UniversityUnited StatesResearchers study ctDNA as a biomarker for cancer treatment response and risk assessment, including in breast cancer and cancer-associated venous thromboembolism.
- ··Hidden research institutionCountryAvailable to registered users, with their key researchers.
- ··Hidden research institutionCountryAvailable to registered users, with their key researchers.
Where circulating tumor DNA innovation happens
Share of documents with at least one organization from each country.
Open the interactive map with all 3,000 organizationsMain technical approaches
Last 24 months| Approach | What it is | Documents | Leading organizations |
|---|---|---|---|
| Tumor-informed sequencing | Tracks mutations identified from a patient’s tumor, enabling personalized residual-disease monitoring but requiring tumor tissue and a tailored assay. | 529 |
Natera, MRD, LabCorp |
| Tumor-naive targeted sequencing | Tests a predefined panel without prior tumor profiling, simplifying deployment but limiting detection to the variants included in the panel. | 425 |
Memorial Sloan Kettering Cancer Center, Astrazeneca, Medical University of Vienna |
| PCR-based detection | Uses targeted amplification to detect selected variants, offering focused and sensitive testing but requiring the target mutation to be known in advance. | 399 |
University Hospital of Southern Denmark, University of Southern Denmark, Sygehus Lillebaelt Vejle |
| Methylation profiling | Reads tumor-associated DNA methylation patterns, which can provide signals beyond mutations but requires robust interpretation across tissues and disease states. | 526 |
University Hospital of Southern Denmark, University of Southern Denmark, Juntendo University |
| Fragmentomics and genome-wide profiling | Analyzes genome-wide DNA fragmentation and other broad patterns, potentially finding signals beyond targeted mutations but placing demands on sequencing and analysis. | 287 |
University of Cambridge, Memorial Sloan Kettering Cancer Center, Medical Genetics Institute |
Emerging trends
Last 12 months vs previous 36 monthsTerms whose frequency in the last 12 months grew the most compared with the previous 36 months.
Funding and investment
Recent funding rounds
Grant funding totals $74,888,023 across 43 grants since 2020. These grants support research across the ctDNA field and are distinct from the broader funding-round totals.
Patent landscape
Top patent holders · last 24 monthsRecent developments
Latest news, duplicates removed- Oct 2026BillionToOne, Inc. (BLLN), a molecular diagnostics company, announced on Wednesday the publication of a peer-reviewed study comparing its Northstar Response tissue-free liquid biopsy assay with a commercially available…RTT - Biotech
- Jul 2026A blood test performed only weeks after cancer surgery could help doctors decide who should receive chemotherapy and who may be able to avoid it, according to new research presented at the ESMO Gastrointestinal Cancers…Knowridge Science Report
- Jul 2026Colorectal cancer is one of the most common cancers in the world and is also one of the leading causes of cancer deaths. It begins in the colon or rectum and can spread to other organs if it is not fully controlled. The…Knowridge Science Report
- Jul 2026Dublin, July 01, 2026 (GLOBE NEWSWIRE) -- The "Oncology Precision Medicine Market - Global Industry Size, Share, Trends, Opportunity, and Forecast, 2021-2031F" has been added to ResearchAndMarkets.com's offering. The…GlobeNewswire - Research Analysis And Reports
- Month 20XXHidden developmentAvailable to registered users with alerts enabled.
Frequently asked questions about circulating tumor DNA
What companies are working on circulating tumor DNA?
Natera, Guardant Health and Foundation Medicine are among the companies active in ctDNA. Natera’s Signatera is being evaluated for treatment de-escalation and is used to track residual disease and response. Guardant Health profiles tumor-derived alterations and has filed a methylation-based assay patent. Foundation Medicine works on ctDNA profiling in advanced solid tumors and related outcome research.
Which circulating tumor DNA startups are the most promising in 2026?
GRAIL, Foresight Diagnostics and BillionToOne are notable startups in ctDNA-related work. GRAIL develops Galleri, a blood-based multicancer early-detection test. Foresight focuses on ultrasensitive, tumor-informed residual-disease detection, including lymphoma. BillionToOne’s Northstar Response is a tissue-free liquid-biopsy assay, and its work includes molecular counting of methylated ctDNA for treatment-response monitoring.
Which universities and research centers lead circulating tumor DNA research?
The University of Texas M. D. Anderson Cancer Center, Memorial Sloan Kettering Cancer Center and Harvard University are prominent research organizations. M. D. Anderson studies monitoring, recurrence and trial endpoints across tumor types. Memorial Sloan Kettering investigates treatment outcomes, recurrence surveillance and targetable alterations. Harvard researchers study ctDNA in treatment response and risk assessment.
How much funding has circulating tumor DNA received?
Grant funding totals $74,888,023 across 43 grants since 2020. The figure reflects grants associated with the ctDNA landscape, rather than a complete measure of private investment or company financing. The data also lists funding rounds, but those totals may include broader company activity and should not be treated as ctDNA-specific investment.
Who holds the most circulating tumor DNA patents?
Foundation Medicine leads the listed patent holders with 28 patents, followed by Guardant Health with 16 and Natera with 13. Myriad Womens Health Inc. has 12, while Flagship Pioneering Innovations VI LLC. has 9. Stanford University is also among the leading holders, with 7 patents.
Is circulating tumor DNA patent activity growing?
No: patent activity declined 59.6% in the latest 12-month comparison, while publication activity grew 18.7%. The figures point to continued research expansion alongside a contraction in recent patent output. Patent activity differs by method, with tumor-naive targeted sequencing and methylation profiling among the approaches with recent patents.
What are the main approaches in circulating tumor DNA and how do they differ?
The main approaches are tumor-informed sequencing, tumor-naive targeted sequencing, PCR-based detection, methylation profiling, and fragmentomics and genome-wide profiling. Tumor-informed assays track mutations found in a patient’s tumor, while tumor-naive panels test predefined targets without tumor profiling. PCR focuses on selected variants; methylation and fragmentomic methods seek broader molecular signals.
What are the applications of circulating tumor DNA?
ctDNA applications include prognostic stratification, minimal residual disease, early cancer detection, therapy selection and treatment-response monitoring. Prognostic stratification has 2,737 documents, while minimal residual disease has 1,846. Current research also examines ctDNA in cancers including colorectal, breast, melanoma, bladder and oesophageal cancer.
What are the latest developments in circulating tumor DNA?
Recent developments include ALFAssay, a fragmentomics-based neural-network method reported in August 2026, and a ctDNA-monitoring patent filed by Stanford University and Foresight Diagnostics in September 2026. In October 2026, BillionToOne reported high concordance for its Northstar Response assay in an advanced-cancer study. Research is also testing ctDNA-guided treatment decisions and serial monitoring across cancer types.