Liquid biopsy is now standard of care for all patients with advanced lung cancer in Wales, significantly reducing the time to molecular diagnosis and enabling eligible patients to start life-extending targeted treatments sooner.
The QuicDNA collaboration, was a two-year programme that brought together NHS Wales, industry and the third sector to establish how liquid biopsy could be successfully integrated into routine lung cancer care. As one of the contributing partners, Moondance Cancer Initiative helped support the evidence, clinical confidence and operational learning needed to embed liquid biopsy into routine lung cancer care. More than 700 patients took part, with some receiving life-extending targeted treatments that would otherwise have been delayed or unavailable.
Lung cancer is the third most common cancer in Wales and remains the leading cause of cancer death. Most patients are diagnosed at an advanced stage, when treatment options have historically been limited and survival is poor. Advances in precision medicine now mean that some patients can receive highly effective targeted treatments, but only if their cancer carries specific genomic alterations that can be identified quickly.
Traditionally, identifying these genomic alterations has relied on obtaining tumour tissue through a biopsy. For patients with advanced lung cancer, this can be technically difficult, invasive and, in some cases, impossible. Liquid biopsy uses a simple blood sample to detect tumour DNA circulating in the bloodstream, allowing the same clinically relevant genomic alterations to be identified without the need for additional invasive procedures in many patients.
Liquid biopsy also delivers results considerably faster than tissue testing. During the QuicDNA programme, the average turnaround time from sample collection to molecular result was 12–16 days for liquid biopsy compared with 23–33 days for tissue testing, enabling eligible patients to begin targeted treatment up to three weeks earlier.
Through the QuicDNA programme, patients underwent both liquid biopsy and standard tissue biopsy. This allowed clinicians to confirm the reliability of liquid biopsy by comparing the genomic results from both approaches while continuing to use tissue biopsy to establish the cancer diagnosis. As confidence in the technology grew and its accuracy was demonstrated, clinicians were increasingly able to use liquid biopsy results to guide treatment decisions without waiting for tissue molecular testing.
In May 2025, liquid biopsy for advanced lung cancer was added to the National Genomic Test Directory, making it standard of care across England and Wales. For patients with advanced lung cancer in Wales, this means faster access to the genomic information needed to guide treatment decisions and earlier access to life-extending precision therapies where appropriate.