UF Health researchers have shown in a pilot study that a noninvasive method of blood testing can effectively detect cancerous liver tumors and evaluate changes in the disease during treatment. The preliminary findings indicate that the technique, measuring methylated circulating tumor DNA, or ctDNA, could allow physicians to assess patients’ tumor burden without the need for invasive tumor biopsies.

“This precision monitoring technique could be used in the postoperative setting to detect how tumors are responding to treatments and allow physicians to make rapid, personalized therapeutic decisions, ultimately improving patient outcomes,” said Ali Zarrinpar, M.D., Ph.D., a professor in the department of surgery in the UF College of Medicine and senior author of the study, which was published recently in the Journal of the American College of Surgeons.
Hepatocellular carcinoma is the third leading cause of cancer death worldwide. Early diagnosis significantly improves the prognosis, especially given that early-stage disease can usually be treated surgically. In cases where the cancer cannot be managed surgically, locoregional treatments such as ablation or radioembolization or systemic therapies such as targeted drugs or immunotherapy may be used. In these patients, frequent, real-time monitoring is vital to improving outcomes so physicians can adjust treatments as needed.
Methylated ctDNA quantification is a type of “liquid biopsy” in which tumors are assessed by analyzing DNA fragments shed by tumor cells into the blood system. Because this can be done only by a blood draw, and not a biopsy, it decreases the risks and discomfort of invasive procedures and reduces the reliance on getting to the tumor with a needle, which can be inaccurate.
By analyzing the blood samples from 25 patients, the UF Health researchers found that the novel methylated ctDNA quantification method, developed by BillionToOne Inc., effectively detected the presence of hepatocellular carcinoma It distinguished patients with cancer from those without cancer, whether after transplantation or after surgical removal.
Notably, unlike prior studies that have primarily tested how the method performs in diagnosing or detecting liver cancer, the researchers also found that the method could detect smaller changes in the tumor burden in between locoregional or systemic treatments.
“This study marks an important first step toward personalized treatment and elevated patient care, and we look forward to future studies exploring the benefits and clinical utility of this blood test,” said lead author Isabella Angeli-Pahim, M.D., a research scholar in the UF department of surgery.
Zarrinpar is a member of the UF Health Cancer Center’s Cancer Targeting and Therapeutics research program. Other coauthors from the Cancer Center are Ilyas Sahin, M.D., and Steven Hughes, M.D. The study received funding from the National Center for Advancing Translational Sciences, which is part of the National Institutes of Health. Research at the UF Health Cancer Center receives crucial support from the Casey DeSantis Cancer Research Act (Fla. Stat. § 381.915).