Following successful national pilots of ctDNA blood tests for detection of non-small cell lung cancer and ESR1 in breast cancer, testing is now available as standard of care. Testing requires NHS Trusts to procure their own sample collection kits, which are then sent to certain regional Genomic Medicine Services (GMSs) for testing.
Non-urgent advice: Webinar 13 July 2026: ctDNA for Cancer of Unknown Primary
From 13 July 2026, patients with Cancer of Unknown Primary (CUP) can be referred for circulating tumour DNA (ctDNA) testing via the NHS Genomic Test Directory.
Already used in non-small cell lung cancer (NSCLC), ctDNA testing uses a simple blood test to detect tumour DNA circulating in the bloodstream. For patients with CUP, this can help:
- Identify the likely tissue of origin
- Detect clinically actionable genomic alterations
- Support diagnosis, treatment decisions and access to clinical trials
To support this rollout, you can join an educational webinar that will walk you through referral pathways and what this means in practice. There are three webinar dates, but clinicians in the East Midland and East of England should attend the 7 July date as this will cover local pathway details specific to the East region.
You can register via the link below:
If you’re unable to attend live, recordings will be shared after the webinars.
Those in the East Genomics region should order tests and send samples to the North Thames GMS. Find out more about ctDNA testing.
We have worked with Trusts across our region to support the funding and procurement of appropriate sampling kits. If you are unsure how to access testing, please contact:
- East of England Cancer Alliance - Liz Lawrence elizabeth.lawrence5@nhs.net
- East Midlands Cancer Alliance - Aisha Minhas aisha.minhas1@nhs.net
Benefits of ctDNA testing
Detection of ctDNA can be a fast and effective way to detect cancer and demand for these tests is expected to continue to grow.
Key benefits of testing include:
- Earlier access to targeted treatments and reduced need for repeated invasive procedures
- System-wide cost savings from diagnostic procedures for patients with failed genomic tests
- Cost savings from avoided mistreatment and associated consequences
- Improved quality of life for patients accessing treatment sooner
- Reduced cancer waiting times