New Data Suggests Potential for Liquid Biopsy in Early-Stage lung Cancer Detection

November 17, 2025 | 5 min read

Early detection is paramount in improving outcomes for lung cancer, but current screening methods have limitations. Now,emerging data suggest that liquid biopsies – blood tests analyzing circulating tumor DNA (ctDNA) – may offer a promising new avenue for identifying early-stage lung cancer,even before its visible on conventional imaging.

Researchers presented findings at the International Association for the Study of Lung Cancer (IASLC) 2025 World Conference on Lung Cancer, detailing a study evaluating the performance of a novel ctDNA assay in a cohort of high-risk individuals. The study enrolled participants with a history of smoking or other risk factors for lung cancer, who were undergoing annual low-dose computed tomography (LDCT) screening.

Blood samples were collected alongside LDCT scans.The ctDNA assay analyzed for specific mutations commonly found in lung cancer. Results showed that the assay detected ctDNA in 13% of participants who were subsequently diagnosed with lung cancer within one year of the blood draw, and importantly, in many cases, before the cancer was detectable on LDCT.

“These findings are encouraging,” said lead investigator Dr. Anya Sharma, a medical oncologist at the University of California, san Francisco. “The ability to detect cancer signals in the blood before radiographic evidence could allow for earlier intervention, perhaps leading to improved survival rates.”

Though, Dr. Sharma cautioned that the assay is not perfect. False positives were observed in approximately 3% of participants,meaning some individuals tested positive for ctDNA but did not develop lung cancer within the study timeframe. This highlights the need for further research to refine the assay and minimize false positives.

“The challenge now is to determine how best to integrate ctDNA testing into existing lung cancer screening protocols,” Dr. Sharma explained.”We need to understand the optimal timing of testing, the frequency of monitoring, and how to manage patients with positive results.”

Several other studies presented at the conference explored different aspects of ctDNA in lung cancer.One study focused on using ctDNA to monitor treatment response, finding that changes in ctDNA levels correlated with clinical outcomes. Another investigated the potential of ctDNA to identify patients at high risk of recurrence after surgery.

Experts agree that liquid biopsies hold significant promise for transforming lung cancer management. While not yet ready for widespread clinical implementation, the growing body of evidence suggests that ctDNA testing could become an integral part of lung cancer screening and treatment in the future.

“Liquid biopsies are not going to replace LDCT screening entirely, at least not in the near future,” said Dr.David Chen, a pulmonologist at Massachusetts General Hospital, who was not involved in the study.”But they could serve as a valuable adjunct,helping us to identify high-risk individuals who may benefit from more intensive monitoring or earlier intervention.”

Further research is ongoing to validate these findings in larger, more diverse populations and to develop more sensitive and specific ctDNA assays. The ultimate goal is to leverage the power of liquid biopsies to improve early detection, personalize treatment, and ultimately, save lives.

PlGF Levels Predict Preeclampsia Risk in Pregnant Women With Sickle Cell Disease

The degree of accuracy with which researchers were able to identify individuals at risk is “fantastic,” according to Kinga Malinowski, MD, MSc, FRCSC, professor of obstetrics/gynecology at McMaster University in Canada. “Patients with sickle cell disease can have complicated pregnancies. We know that the risk of preeclampsia is higher than the general population, and now we can better predict whoS going to develop preeclampsia based on an easily accessible marker.”

Women with sickle cell disease have a two to three times higher likelihood of developing preeclampsia during pregnancy than those who do not.”It can happen to anybody, but individuals with sickle cell disease have a higher risk partly because sickle cell disease is a proinflammatory state,” Malinowski said. “There is significant dysfunction within the blood vessels precipitated by the disease, which impacts placental development and function.”

Preeclampsia can be early-onset (at or before 34 weeks) or late-onset, and the conditions seem to have different origins. “Early-onset disease occurs as of defective placentation because of shallow invasion of the trophoblast, which eventually becomes the placenta, and the failure of uterine arteries to develop into a low-resistance system,” Malinowski said. “Late-onset preeclampsia is more a reflection of placental stress and dysfunction, with imbalance of angiogenic and antiangiogenic factors and often more related to maternal predisposition to cardiometabolic disease.”

PlGF levels rise during pregnancy, peaking at 28 to 30 weeks. Higher levels are associated with a lower likelihood of development of early-onset preeclampsia.

Prior research has shown low PlGF levels have an association with preeclampsia in women without sickle cell disease. Though, the challenge for patients with sickle cell disease is that PlGF is also produced by organs such as the heart, lungs and thyroid, and by red blood cells, even outside of pregnancy. “In individuals with sickle cell disease, there’s such a high turnover of red blood cells as they break down so much more quickly, there are higher levels of PlGF even outside of pregnancy. Those levels rise even further in individuals with sickle cell disease who are sicker and have more of a hemolytic phenotype to their disease.”

Because of this, Malinowski and colleagues wanted to evaluate…

PlGF Levels Show Promise in Predicting Preeclampsia in Women With Sickle Cell Disease

Women with sickle cell disease who develop preeclampsia may be identified using placental growth factor (PlGF) levels, according to research presented at the Society for Maternal-Fetal Medicine annual meeting.

Researchers found that PlGF levels less than 100 pg/mL were associated with a substantially higher risk for early-onset preeclampsia in women with sickle cell disease.

“we were able to show that the same cutoff can be used for patients with sickle cell disease,” Kinga Malinowski, MD, MSc, FRCSC, said. “It is indeed great news that we can continue to use the same cutoffs for patients with sickle cell disease.”

The study included 68 women with sickle cell disease and 136 controls without the condition. Researchers assessed PlGF levels between 12 and 16 weeks of gestation and followed the women for the development of preeclampsia.

Results showed that PlGF levels were significantly lower in women with sickle cell disease who developed early-onset preeclampsia compared with those who did not (68.7 pg/mL vs. 124.6 pg/mL; P* < .001). The area under the receiver operating characteristic curve (AUC) for plgf in predicting early-onset preeclampsia was 0.86 (95% CI, 0.75-0.97).

Women with sickle cell disease who had early-onset preeclampsia had significantly earlier deliveries than those without preeclampsia (31.8 weeks vs. 38.1 weeks; *P = .002).

The researchers also observed that women with sickle cell disease had a higher rate of maternal vascular malperfusion (MVM) within the placenta than the control group. Those with lower PlGF levels had a significantly higher likelihood of MVM at 24 to 28 weeks (P* = .002), 28 to 32 weeks (P* = .015) and beyond 32 weeks (*P* = .015).

MVM has been linked to adverse obstetric outcomes such as preeclampsia, preterm birth, fetal growth restriction and intrauterine fetal demise.

‘same cutoff’

malinowski highlighted the importance of validating these findings in other centers.

“I’m pleasant with the accuracy of the results in our cohort, but certainly we would want to make sure that we can replicate it in other centers and in larger study samples, as well,” she said.

Malinowski and colleagues are also investigating other risk factors that could identify women with sickle cell disease at risk for complications other than preeclampsia.

“We know outside of sickle cell disease that the cutoff of less than 100 pg/mL was very discriminative for predicting early-onset preeclampsia, and we were able to show that the same cutoff can be used for patients with sickle cell disease,” she said.

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Kinga Malinowski, MD, MSc, FRCSC, can be reached at kinga.ob@mcmaster.ca.