Liquid biopsy: companies, startups and research

Guardant Health, Thermo Fisher Scientific, Natera, Illumina and Qiagen are prominent companies in the liquid-biopsy field. Guardant Health develops ctDNA tests for genomic profiling, monitoring and early detection, while Natera’s Signatera assay targets molecular residual disease and recurrence risk. Thermo Fisher Scientific, Illumina and Qiagen supply technologies used in sample preparation, sequencing and molecular assays.

Delfi Diagnostics, BillionToOne and Foresight Diagnostics are startups developing distinct cell-free DNA approaches. Delfi combines fragmentomics, whole-genome sequencing and machine learning; BillionToOne works on ctDNA assays and methylation-based monitoring; and Foresight focuses on ultrasensitive methods for minimal residual disease. Their approaches address different technical needs, so the strongest fit depends on the intended cancer and use case.

The University of Texas M. D. Anderson Cancer Center, Harvard University and Weill Cornell Medicine are active research organizations in liquid biopsy. M. D. Anderson studies ctDNA and circulating tumor cells as response biomarkers, while Harvard research includes blood fractionation and microfluidics. Weill Cornell investigates circulating tumor cells and plasma cell-free DNA, including ESR1 alterations in advanced breast cancer.

Funding data lists $333,042,924 in grants across 192 awards since 2020. This is the clearest funding figure available for the field. The broader recorded funding-round total is $79,698,876,228 across 31 rounds, but the round entries include activity that is not clearly specific to liquid biopsy and should not be treated as a clean sector total.

Foundation Medicine holds 43 patents in the listed holder data, followed by Guardant Health with 41. Natera has 15, Tempus AI has 14, and Myriad Womens Health Inc. has 13. These counts identify prominent holders in the dataset; they do not indicate patent quality, enforceability or the commercial value of the underlying inventions.

Patent activity declined 57.6% in the last 12 months versus the previous 12 months, while 537 patents were recorded in the 24-month window. Publication activity moved in the opposite direction: publications grew 16.5% in the last 12 months versus the previous 12 months. This divergence suggests continued research interest alongside a slower recent patenting pace.

Recent developments include research on long-read sequencing and liquid-biopsy detection of therapy resistance. A September 2026 publication from Johns Hopkins University examines resistance in thoracic malignancies, while an August 2026 review from the University of Arkansas for Medical Sciences discusses long-read sequencing as an alternative to short-read methods. Research also continues on circulating RNA, extracellular vesicles and biomarkers for minimal residual disease.

Five main approaches are cell-free DNA genomics, circulating tumor cells, extracellular vesicles, circulating RNA, and protein and metabolic biomarkers. DNA genomics supports mutation-based profiling, while cell analysis can reveal intact-cell features. Vesicles and RNA provide other tumor-associated signals; protein and metabolic tests add non-genomic markers. Each method faces different challenges in signal abundance, capture, assay consistency or tumor specificity.

The United States leads with 28,892 documents, followed by China with 15,087 and the United Kingdom with 7,793. Germany and Italy also have substantial activity, with 6,732 and 5,825 documents respectively. These figures describe the geographic distribution of recorded activity, not the relative clinical adoption or commercial strength of liquid-biopsy technologies in each country.

Liquid biopsy applications include early cancer detection, molecular profiling, treatment-response monitoring, minimal residual disease detection and recurrence surveillance. The strongest recent application growth is in minimal residual disease, which grew 55.4% in the last 12 months versus the previous 12 months. These applications use tumor-derived signals to inform detection or follow disease over time, but their clinical role depends on the test and setting.