Precision oncology has traditionally relied on tissue obtained at a single point in time, yet lung cancer is a dynamic disease that continuously evolves under treatment pressure. Liquid biopsy is transforming this paradigm by providing a minimally invasive method to characterise tumour biology repeatedly throughout the patient's journey, from diagnosis to survivorship and advanced disease.
This presentation will explore the expanding clinical role of circulating tumour DNA (ctDNA) across the lung cancer continuum. At diagnosis, plasma genomic profiling can accelerate molecular identification, reduce time to treatment, complement tissue testing, and improve access to targeted therapies when tissue is limited or delayed. During curative-intent management, emerging evidence supports ctDNA as a highly sensitive marker of molecular residual disease, enabling earlier detection of recurrence and providing the foundation for risk-adapted adjuvant and surveillance strategies. In advanced disease, serial ctDNA monitoring offers unique insights into treatment response, clonal evolution, resistance mechanisms, and the selection of subsequent targeted therapies and clinical trials.
Rather than representing a replacement for tissue, liquid biopsy is becoming an essential complementary technology that enables real-time precision medicine. As evidence continues to mature, integrating longitudinal molecular monitoring into routine clinical practice has the potential to improve patient outcomes, optimise therapeutic decision-making and fundamentally reshape the management of lung cancer across the entire disease trajectory.