Liquid Biopsy ­– The key to cancer diagnostics, monitoring and treatment

Accelerating the commercialization of non-invasive tests for liquid biopsy of solid tumor cancers. (LIQ-BIOPSY)

Cancer is not one disease, but several – which partly explains the complexity and variability in treatment, management and prognosis of patients. In 2018, there were over 18 million people diagnosed with cancer, and more than 9 million deaths because of it1. By 2030, due to population growth and increased life expectancy, the number of new cases is expected to increase to 21 million, with the number of deaths rising to 13 million2. Cancer is defined as the uncontrollable growth of mutated (altered) cells, and an important factor contributing to cancer management and survival are the tools used today to diagnose, treat and monitor a person with cancer.

Indisputably, the key to effective cancer control and one of the global challenges to reducing the impact of cancer is diagnostic delays. If cancer is detected early, when the tumor is still small and hasn’t metastasized to other organs yet, chances of successful treatment are higher. Currently, cancer detection is achieved via screening and diagnostic tests. Screening tests are used as a first line of cancer detection to identify a small group of people that are high-risk of having cancer and to refer them for diagnostic tests. Screening tests are usually simpler and less invasive than diagnostic tests, which give a definite answer on whether the patient has cancer.

Screening procedures include colonoscopy for colorectal cancer; analysis of prognostic biomarkers like evaluating the CA-125 levels through a blood test for ovarian cancer; and medical imaging, such as a screening mammography for breast cancer. Screening tests can be useful as a first line of detection because of their simplicity, but some limitations exist as they could still be invasive, painful, or subject patients to harmful radiation. Additionally, not all cancers have a reliable screening test. Lastly, some screening tests have low specificity, and thus may unnecessarily refer many patients for intrusive diagnostic tissue biopsies. The biggest shortcoming of screening tests though, is that they detect cancer when it has become prominent – not during the early stages, where immediate response is critical and most beneficial.

Currently, traditional cancer diagnostics also face challenges related to feasibility (a tissue biopsy for a lung cancer may not always be achievable), and the delay in recovering from these invasive procedures which could further stress the immune system and compromise the efficiency of cancer therapy. Further limitations include the inability to obtain a fully accurate genomic picture of the tumor as this depends on the biopsy site and the cells collected. Advanced and metastatic cancers especially tend to be heterogeneous (composed of different genetic mutations), and therefore, a single biopsy from one tumor site may not represent the whole tumor.

Hence, an area of particular interest in the cancer field is the liquid biopsy test. Performed via a simple blood draw, a liquid biopsy test can detect circulating tumor DNA (ctDNA) released into the bloodstream from cancerous cells and tumors3. This ctDNA varies from ‘normal’ DNA as it has acquired genetic mutations related to the tumor. Therefore, detection of ctDNA can be key for early cancer detection and diagnosis.

Liquid biopsy tests offer advanced sensitivity than conventional detection methods because ctDNA has tumor characteristics from all cancerous sites in the body and can assess tumor heterogeneity that could otherwise go unnoticed in a traditional tumor biopsy. By providing an accurate picture of the disease, liquid biopsy testing could help in providing tumor-specific treatment via targeted therapies. Looking at the particular mutations in a patient’s sample will allow their physician to determine the most appropriate treatment option and prescribe therapies that are the most effective for the specific mutations present. This has the potential to cause less side effects for the patients, and will undoubtedly provide them with the best chances of successful treatment. Additionally, liquid biopsy can work as a prognostic tool, tracking and assessing the risk of relapse and prognosis of patients, and of acquired treatment resistance over the course of therapy via serial blood-draws which would examine the changing ctDNA. Liquid biopsy is the ideal test for serial testing, due to its fast, painless and safe application – this would not be possible with conventional cancer diagnostics due to the tests’ invasiveness. For example, a study on colorectal cancer has demonstrated that ctDNA levels indicating recurrence were detected on average 10 months before cancer relapse was picked up by other methods4. This indicates that liquid biopsy can monitor tumor dynamics and detect disease much earlier than other means, which would be extremely beneficial for quick medical action and effective treatment that could prove life-saving.

Lastly, the key advantage of liquid biopsy testing is how early the test can detect cancer. Compared to current screening and detection methods that confirm the presence of cancer typically after the onset of symptoms, a liquid biopsy can identify ctDNA presence in the bloodstream much earlier. This is integral in preventing metastasis and encouraging improved chances of treatment.

The presence of ctDNA in the bloodstream is well-known for over 20 years3. The extremely low volume of ctDNA compared to non-pathogenic DNA makes the design of a ctDNA test intricate and challenging. The story of ctDNA is similar with that of cell-free fetal DNA (cffDNA). More than two decades have passed since the discovery of cff-DNA in 1997, to the routine implementation of non-invasive prenatal tests (NIPT) to pregnant women of all ages. Implementation of next generation sequencing for cell-free fetal DNA detection revolutionized prenatal testing by allowing for the detection of multiple aneuploidies, microdeletions and even single gene disorders prenatally; informing prospective parents and healthcare providers of the health of the unborn baby and allowing them to take informed decisions regarding management and possible treatment. With the leaps of technological advances we have witnessed in recent years, the wealth of information obtained and the ability of the scientific community to transform these into clinical actions, the application of liquid biopsy into clinical practice will soon be a reality that will benefit millions.

NIPD Genetics is currently developing a liquid biopsy assay for the detection of cancer using ctDNA. In line with NIPD Genetics’ vision of providing safe, sensitive and reliable tests, our liquid biopsy assay will provide valuable clinical utility for the detection of solid cancers, and would have applications in many clinical decision-making points such as early cancer detection, diagnosis, monitoring of tumor dynamics, identification of mutations for targeted therapy and assessment of treatment resistance. Leveraging our powerful technology, we aim to bring to the market an affordable and accurate liquid biopsy assay that will benefit and revolutionize cancer care worldwide. 70% of this research is funded by the Research and Innovation Foundation, Cyprus, under the program RESTART 2016-2020 after receiving the Seal of Excellence from the European Commission5 under the H2020 program.


  1. World Health Organization Press Release (2018). ‘Latest global cancer data: Cancer burden rises to 18.1 million new cases and 9.6 million cancer deaths in 2008’. International Agency for Research on Cancer.
  2. World Health Organization (2019) ‘Key Statistics’,
    Sorenson GD., et al. (1994) ‘Soluble normal and mutated DNA sequences from single-copy genes in human blood. Cancer Epidemiology, Biomarkers & Prevention; 3(1): 67-71
  4. Reinert T., et al. (2016) ‘Analysis of circulating tumor DNA to monitor disease burden following colorectal cancer surgery’. Gut; 65:625-634

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NIPD Genetics - Privacy Policy

General Statement

NIPD Genetics is a leading, innovative biotechnology company that designs, develops, and provides a broad spectrum of healthcare services to its customers through its expansive portfolio of molecular and clinical laboratory tests in all disciplines.

At NIPD Genetics we are committed to protecting and respecting our customer’s privacy and personal information. Personal information or personal data means any information that identifies, relates to, describes, is capable of being associated with, or could be reasonably linked, directly or indirectly, with a particular individual, such as name, identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that individual.

NIPD Genetics collects and processes your personal information according to the General Data Protection Regulation (EU) 2016/679 and the Cypriot law providing for the protection of natural persons with regards to the processing of personal data and for the free movement of such data (L. 125(I)/2018). The following principles lie at the heart of our approach to handling personal data:

NIPD Genetics has appointed a Data Protection Officer (DPO) who is responsible for overseeing and ensuring that personal information is collected and processed in line with these principles. The contact details of the Data Protection Officer (DPO) can be found below:

Email address:

Postal address: 31 Neas Engomis street, 2409 Engomi, Nicosia, Cyprus

Telephone number: + 357 22266888

By accessing or using our products or services, or by transmitting information to us by email or other electronic means, you accept our policies, procedures and practices described in this Privacy Policy. If you do not agree with our policies, procedures and practices as described, you can choose not to access or use our products or services or not to transmit personal information to us.

This Privacy Policy applies to NIPD Genetics facilities, its websites,, and their subdomains, that link to this privacy pol icy.


We collect and process several types of personal information from and about users of our websites and of our products and services, including:

Information about children

If you are under 18 years of age, do not register on our website or provide any information about yourself to us. We do not provide our products or services directly to children or proactively collect their personal information. Despite this prohibition, it is possible that we may sometimes be given information about children while handling samples from our customers in our clinical labs, or through use of our products and services by our customers and partners. If we become aware that we have inadvertently collected personal information from children under the age of 18, without parental consent, we will take the necessary steps to delete it as soon as possible in compliance with applicable laws.


Your personal information is collected by NIPD Genetics for the following purposes:

  1. To provide you with our products and services, respond to your inquiries or fulfill your requests and otherwise manage your relationship with us. The legal basis for processing is to meet the requirements of a contract, to comply with our legal obligations and/or because we have a legitimate interest in responding to requests for information about our products and services.
  2. To communicate with you about content and product offerings, newsletters and event invitations which are relevant to your interests and in line with your preferences. The legal basis for processing is the individual’s explicit consent prior to sending the information and managing individuals preferences.
  3. To process and respond to complaints. The legal basis for processing is to meet a legal obligation.
  4. To monitor and record information relating to the use of our products and services, including our website. The legal basis for processing is our legitimate interest in order to improve our products and services and our website for individuals.

To provide our products and services, NIPD Genetics may collect, receive and process biological samples to isolate and sequence DNA. NIPD Genetics may then store resulting genetic information and use genetic information to provide our products and services. In some cases, NIPD Genetics may provide interpretations of genetic information on behalf of its customers, including healthcare providers. This is only done pursuant to a written contract or a Sample Information Form with a patient’s informed consent and is subject to applicable legal and ethical safeguards.

This sensitive information described above is collected by NIPD Genetics for the following purposes:

  1. To provide support and maintenance services to customers who use our products and services – The legal basis for processing is to meet the requirements of a contract.
  2. To provide genotyping and sequencing services and analysis for our customers, including healthcare providers. The legal basis of this processing is to meet the requirements of a contract or as allowed in the Sample Information Form with a patient’s informed consent.
  3. To conduct genotyping and sequencing services and analysis for quality control, process and product development and improvements, and optimization in our labs to reflect quality improvements and advances in our technology. The legal basis for processing is the patient’s informed consent given through the Sample Information Form.

Transfer of Data

Your information, including personal data, may be transferred to - and maintained on - computers located outside your province, country or other governmental jurisdiction where the data protection laws may differ than those from your jurisdiction.

If you are located outside Cyprus and choose to provide information to us, please note that we transfer the data, including personal data, to Cyprus and process it there.

Your consent to this Privacy Policy followed by your submission of such information represents your agreement to that transfer.

NIPD Genetics will take all reasonable steps necessary to ensure that your data is treated securely and in accordance with this Privacy Policy and no transfer of your personal information will take place to an organization or a country unless there are adequate controls in place including the security of your data and other personal information.

Disclosure of Data

NIPD Genetics complies with the General Data Protection Regulation and will not sell or trade your personal information.

NIPD Genetics may disclose your personal information in the good faith that such action is necessary:


Cookies are files with small amount of data which may include an anonymous unique identifiers. Cookies are sent to your browser when you visit a website and stored on your device. Tracking technologies used on the website are beacons, tags and scripts, to collect and track information and to improve and analyze our websites.

We use cookies and similar tracking technologies to track the activity on our websites and collect certain information. This includes information about the computer or device you are using, such as Internet protocol (IP) address, information about the browser type or version, the pages of our website that you visit, the time and date of your visit, the time spent on those pages, unique device identifiers and other diagnostic data.

You can instruct your browser to refuse all cookies or to indicate when a cookie is being sent. However, if you do not accept cookies, you may not be able to use some portions of our websites.

Examples of Cookies we may use:

Session Cookies. We use Session Cookies to operate our websites.

Preference Cookies. We use Preference Cookies to remember your preferences and various settings.

Security Cookies. We use Security Cookies for security purposes.

Visitor behavior cookies. To understand how visitors use and navigate the websites

Keyword cookies. To understand how visitors discover the websites.


We may use third-party Service Providers to monitor and analyze the use of our websites.

Google Analytics

Google Analytics is a web analytics service offered by Google that tracks and reports website traffic. Google uses the data collected to track and monitor the use of our service. This data is shared with other Google services. Google may use the collected data to contextualize and personalize the ads of its own advertising network.

You can opt-out of having made your activity on the Service available to Google Analytics by installing the Google Analytics opt-out browser add-on. The add-on prevents the Google Analytics JavaScript (ga.js, analytics.js, and dc.js) from sharing information with Google Analytics about visits activity.

For more information on the privacy practices of Google, please visit the Google Privacy & Terms web page


We are committed to protecting the security of the information we collect, and we take reasonable physical, technical, and administrative safeguards such as data anonymization and encryption to help protect personal information from unauthorized or inappropriate access or use. It is your responsibility to protect the confidentiality of your passwords, and any other access features associated with your access or use of the website or our products and services, as well as to adhere to any applicable Terms of Use or other contract between us and you or your organization.


We may retain collected information even after you remove it from the website, our Services, or our Products, to comply with applicable law, to resolve disputes, to enforce any rights in connection with the website, our Services, or our Products, and to use as provided in this Privacy Policy, the Terms of Use, or an applicable contract between us and you or your organization. How long we retain specific personal information varies depending on the purpose for its use and we may delete or retain your personal information in accordance with applicable law.


We may employ third party companies and individuals to facilitate, maintain or operate our websites (“Service Providers”), to provide the websites on our behalf, to perform service-related services or to assist us in analyzing how our websites are used.

These third parties have access to your Personal Data only to perform these tasks on our behalf and are obligated not to disclose or use it for any other purpose.


Our websites may contain links to other sites that are not operated by us. If you click on a third-party link, you will be directed to that third party's site. We strongly advise you to review the Privacy Policy of every site you visit.

We have no control over and assume no responsibility for the content, privacy policies or practices of any third-party sites or services.


This Privacy Policy may be updated from time to time. We will notify you of any changes by posting the new Privacy Policy on this page.

We will let you know via email and/or a prominent notice on our website, prior to the change becoming effective and update the “effective date” at the bottom of this Privacy Policy.

You are advised to review this Privacy Policy periodically for any changes. Changes to this Privacy Policy are effective when they are posted on this page.


NIPD Genetics ensures that it can respond immediately to requests that you make for the exercise of your legal rights in accordance with data protection laws. These rights are as follows:

You also have the right to lodge a complaint at any time to the Office of the Commissioner for Personal Data Protection.

We encourage you to contact us, should you wish to practice any of your legal rights or you have any questions about this Privacy Policy, by sending an email to NIPD Genetics’ Data Protection Officer at

Effective date: 18/06/2021

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