Cancer care is entering a new era where understanding what remains after treatment is becoming an increasingly important part of personalized cancer care.
As treatments become more personalized and effective, clinicians increasingly need insight into whether residual disease remains after therapy. Molecular residual disease (MRD) testing is helping address that need, moving from a promising research innovation toward a more practical component of routine oncology care.
The launch of the next-generation, whole-genome Oncodetect® test reflects this evolution, bringing together advances in ultrasensitive mutation detection, tumor-informed monitoring and workflow integration to provide clinicians with molecular insights across the continuum of cancer care.
Cancer Care Has Reached an Inflection Point
Across many cancer types, growing evidence is exploring the role of MRD testing in assessing treatment response and recurrence risk. Tumor-informed assays such as the Oncodetect test are designed to detect circulating tumor DNA (ctDNA) over time, offering a molecular view of disease dynamics.
Longitudinal monitoring, spanning treatment and surveillance, can provide additional information about disease status while complementing imaging and pathology. As a result, MRD is evolving from a retrospective prognostic tool to a more proactive input into clinical decision-making.
Seeing What Was Previously Difficult to Detect
As MRD moves closer to routine oncology care, health systems are beginning to consider what it will take to use these tools meaningfully in practice. One consideration is sensitivity, particularly during or after treatment when only small amounts of ctDNA may be present.
The next-generation Oncodetect® test, powered by MAESTRO technology, is designed to detect ctDNA at ultra-low levels, adding molecular information that can complement other tools clinicians use to monitor disease over time.
MRD is Evolving Beyond Detection
As MRD evolves, the conversation is expanding from whether residual disease can be detected to how molecular insights may support clinical decision-making.
When tumor-burden is exceptionally low, finding residual disease can be challenging. The next generation Oncodetect test is designed to detect ctDNA at these ultra-low levels.
Powered by MAESTRO technology, the test combines whole-genome sequencing with the ability to track up to 5,000 tumor-specific variants and detect circulating tumor DNA at ultrasensitive levels, including in low-shedding tumors. This approach is designed to provide clinicians with confidence when making decisions after surgery, during surveillance and while monitoring treatment response.
Innovation Matters Most When It Fits into Clinical Practice
Even with strong evidence, implementation depends on whether testing can fit into clinical workflows.
That is beginning to change with the integration of precision oncology tools directly into electronic medical record (EMR) systems. Abbott’s integration of its oncology portfolio, including the Oncodetect test, into Flatiron Health’s OncoEMR platform is one example of how infrastructure is catching up to innovation.
Through this integration, clinicians can order MRD testing and access results within their existing workflows. With reach across more than 1,600 community cancer centers and thousands of providers, this type of integration extends advanced testing into community care settings where much of cancer care is delivered.
For health systems, EMR integration helps make MRD testing easier to order, track and manage within existing workflows.
Academic Partnerships Are Building the Evidence Base
Alongside infrastructure, academic collaboration plays a key role in advancing MRD testing. Partnerships with leading institutions are helping generate evidence and explore how tests are used in real-world settings.
“As MRD testing becomes more integrated into routine breast cancer care, it has the potential to help clinicians personalize treatment and surveillance based on a more dynamic understanding of disease status,” said Dr. Priya Rastogi, Professor of Medicine at UPMC Hillman Cancer Center. “Continued progress in clinical utility evidence and workflow integration, as well as access, will be key to broader adoption in everyday practice.”
These collaborations can help translate clinical evidence into practical approaches for incorporating MRD testing into everyday care.
From Innovation to Implementation
Taken together, these developments point to a broader shift as MRD testing moves from research settings toward becoming part of the operational fabric of cancer care.
For health system leaders, that raises practical questions: Where can MRD provide meaningful clinical information? How should results fit within existing workflows? What evidence, infrastructure and access are needed to support appropriate use?
As the evidence base grows and supporting infrastructure matures, answering those questions will be important to determining the role MRD ultimately plays in routine cancer care.
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