Blood Test Could Enable Earlier Detection of Liver Cancer Recurrence After Transplant

Disease recurrence after liver transplantation is common and is associated with poor outcomes, underscoring the need for improved post-transplant surveillance. A new study shows that a personalized circulating tumor DNA (ctDNA) blood test could provide earlier warning of post-transplant recurrence while reducing reliance on invasive monitoring procedures.

The study, led by investigators at the Houston Methodist Research Institute (Houston, TX, USA), aimed to determine whether blood-based circulating tumor DNA detection could identify cancer recurrence earlier than, or alongside, standard post-transplant surveillance methods such as imaging and conventional tumor markers.

In the prospective investigation conducted at Houston Methodist, 38 liver transplant recipients underwent ctDNA testing alongside imaging and conventional tumor markers. The study, published in the Journal of Gastrointestinal Oncology, is described as the largest to date in the United States examining a personalized blood test for detecting post-transplant liver cancer recurrence, with more than 720 samples collected and analyzed. 

During the study period, imaging identified recurrence in six patients. Three of these had a corresponding positive ctDNA result, while three had ctDNA results that were negative or insufficient for processing. Among patients with adequate ctDNA testing, specificity was 100%, with no false-positive ctDNA results observed. As the first prospective study of its kind in this area, the authors note that additional studies are needed before clinical adoption.

Chief of GI Medical Oncology at Houston Methodist, Dr. Maen Abdelrahim, said “Detecting cancer recurrence early can change everything, especially amongst the post-transplant population. That means we can act sooner and monitor patients more closely. For liver cancer, where recurrence is common and outcomes are poor when the cancer comes back, this research is a big step toward giving patients a better chance of survival.”

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