Liquid biopsy and ctDNA assay landscape (2026 reference)
Reference snapshot of approved liquid-biopsy assays, the indications they cover, and the reimbursement footprint behind them.
Liquid biopsy and ctDNA assays in 2026 cover several distinct use cases. Treatment-selection assays (Guardant360, FoundationOne Liquid CDx) are approved in NSCLC and increasingly in breast, prostate, and colorectal. MRD-monitoring assays (Signatera, Natera) are growing fastest in colorectal and breast. Multi-cancer early-detection assays (Galleri, Shield) are commercial in screening but reimbursement coverage remains patchy.
Treatment-selection liquid biopsy in NSCLC has Medicare coverage and broad commercial coverage. MRD monitoring is reimbursed in colorectal post-curative-intent surgery in selected payers and is expanding. Multi-cancer early detection has limited insurance coverage and is mostly self-pay or employer-sponsored.
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