This report, produced under JA PCM WP10 (Tertiary prevention), maps the implementation of Liquid Biopsy (LB) and Minimal Residual Disease (MRD) monitoring for tertiary cancer prevention across 49 institutes in 24 European countries. Targeted at healthcare policymakers, clinical directors, and oncology professionals, it identifies the structural and economic challenges hindering the integration of these methodologies into routine European cancer care.
Key findings reveal a significant "implementation gap": while 73.5% of participating centres have established the foundational infrastructure for LB, only 41.7% currently apply it to tertiary prevention, such as early relapse detection. The analysis identifies systemic bottlenecks rather than technical failures as the primary hurdles, specifically a lack of clinical validation and high operational costs. A major economic disconnect exists, with current costs (often 600–1000€ per sample) far exceeding the sustainable target of 100–300€ identified by the majority of centres.
Despite these barriers, there is a unanimous (100%) expectation of growth by 2030, with MRD monitoring emerging as the definitive clinical priority across all European macro-regions. To bridge this gap, the report recommends: standardization of pre-analytical workflows to ensure data reproducibility; evidence generation to support the clinical guidelines and reimbursement models requested by healthcare providers; economic sustainability initiatives to align molecular surveillance costs with hospital feasibility.
Ultimately, this report provides the evidence-based foundation required to transition LB into a cornerstone of standard clinical practice, ensuring equitable access to advanced post-treatment surveillance across the European Union.