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MRD Research:
Faint signals, fast timelines
Explore how today’s molecular residual disease (MRD) technologies are shaping tomorrow’s MRD developments.
Does your panel manufacturer meet your research timelines?
Molecular signals from ctDNA sequencing can appear well before other imaging methods pick up a signal. The most sensitive approaches result in a tumor-specific panel, a process that can take up to four weeks. Faster panel design keeps your MRD research moving.
Reduce panel manufacturing time and keep your MRD research moving
Target enrichment
Circulating tumor DNA (ctDNA) in a tube of blood plasma is finite. Sequencing it requires a choice between looking widely across the whole genome, or deeply at a defined set of variant sites.
Whole genome sequencing
Best for tracking thousands of tumor-specific variants genome-wide — also powers tumor/normal profiling, tumor-naive MRD research, and methylation-based approaches.
Target enrichment
Best for tumor-informed MRD research panels deep enough to separate signal from error — also powers tumor/normal profiling, tumor-naive MRD research, and targeted methylation panels.
Tumor-naive or tumor-informed ctDNA detection?
Detecting ctDNA in blood is like finding a needle in a haystack. Yet knowing what kind of needle you're seeking is helpful. That’s why tumor-informed panels from Twist, with up to 10,000 probes tracking thousands of tumor-specific genetic targets, may deliver greater sensitivity than tumor-naive panels.
Tumor-naive
Best when tissue is not available, or where targets must match across studies.
|
Panel customization |
Low |
|---|---|
|
Sensitivity |
Moderate |
|
Targets tracked |
Fixed |
Tumor-informed
Best for tracking variants confirmed in an individual tumor, down to the lowest tumor fractions.
|
Panel customization |
High |
|---|---|
|
Sensitivity |
Very high |
|
Targets tracked |
Up to 10,000 |
Amplicon or hybrid capture-based enrichment?
Once an MRD panel's targets are chosen, they still have to be pulled out of the cell-free DNA background. Hybrid-capture and amplicon-based (PCR) enrichment do this differently, which shows up in marker capacity and sensitivity.
Amplicon
Best for small, fixed panels where cost per sample matters most.
|
Sensitivity (LoD₉₅) |
Lower |
|---|---|
|
Marker/target scalability |
Capped — realistically dozens to ~60-70 variants |
|
Tumor-informed panel manufacturing time |
Weeks, depending on design and validation |
|
Design process |
Complex |
Hybrid Capture
Best for tumor-specific panels where sensitivity at low fraction is key.
|
Sensitivity (LoD₉₅) |
Higher |
|---|---|
|
Marker/target scalability |
Scales to thousands of variants |
|
Tumor-informed panel manufacturing time |
Can be completed in a matter of days |
|
Design process |
Simplified with MRD Express |
Sources: Santonja et al. (Reference 4); Ryoo et al. (Reference 7); Natera (Reference 9); Johnston et al. (Reference 11); Twist Bioscience, MRD Express product sheet (Reference 12).
More targets, more sensitivity
A significant share of ctDNA-based MRD research occurs at tumor fractions below 100 ppm. Tracking more tumor-specific targets creates more opportunities for detection, increasing assay sensitivity.* Click the scenarios below to see how the number of panel targets can affect sensitivity as tumor fraction decreases.
Choose your targets
Choose your targets
Higher tumor burden
|500 ppm
Sensitivity
100%
Blood tubes to reach 95%
1 tube
Low tumor burden
|100 ppm
Sensitivity
75%
Blood tubes to reach 95%
2 tubes
Ultra-low tumor burden
|5 ppm
Sensitivity
<1%
Blood tubes to reach 95%
35 tubes
With 16 targets, sensitivity is above a 95% LoD threshold at 500 ppm but falls below that to 75% at 100 ppm, and under 1% at 5 ppm. Recovering that sensitivity by sampling more would take 2 tubes of blood at 100 ppm and a highly impractical 35 tubes at 5 ppm.
*Based on Muzzey, D. Ultra-sensitive molecular residual disease detection with Myriad's Precise MRD test. Sponsored Industry Expert Theater presentation, ASCO Annual Meeting, Chicago, Illinois, USA (2026). Used with permission.
NEW
Introducing MRD Express
MRD Express ships a tumor-informed panel within a day after design submission.** Track thousands of tumor-specific variants using hybrid capture enrichment, while keeping your MRD research moving at full speed.
Twist solutions for your MRD research
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Connect with our technical team and let’s see how we can
advance your MRD research.
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**Turnaround times are estimates only and are not guaranteed. Actual turnaround may vary based on order specifications, sample characteristics, processing requirements, operational capacity, and other applicable factors. Product information, specifications, features, availability, and timing are subject to change without notice. Twist products are for research use only. They are not intended for the diagnosis, prevention, monitoring, or treatment of a disease or condition. Twist Bioscience assumes no liability regarding the use of its products in unintended applications.
References:
- Kotani D, Oki E, Nakamura Y, et al. Molecular residual disease and efficacy of adjuvant chemotherapy in patients with colorectal cancer. Nature Medicine. 2023;29(1):127-134. doi:https://doi.org/10.1038/s41591-022-02115-4
- Yang Y, Lu Y, Tan H, et al. The optimal time of starting adjuvant chemotherapy after curative surgery in patients with colorectal cancer. BMC Cancer. 2023;23(1):422. doi:https://doi.org/10.1186/s12885-023-10863-w
- Samorodnitsky E, Jewell BM, Hagopian R, et al. Evaluation of hybridization capture versus amplicon-based methods for whole-exome sequencing. Human Mutation. 2015;36(9):903-914. doi:https://doi.org/10.1002/humu.22825
- Santonja A, Cooper WN, Eldridge MD, et al. Comparison of tumor-informed and tumor-naïve sequencing assays for ctDNA detection in breast cancer. EMBO Molecular Medicine. 2023;15(6):e16505. doi:https://doi.org/10.15252/emmm.202216505
- Chen K, Shields MD, Chauhan PS, et al. Commercial ctDNA assays for minimal residual disease detection of solid tumors. Molecular Diagnosis & Therapy. 2021;25:757-774. doi:https://doi.org/10.1007/s40291-021-00559-x
- Ma D, Gao X, Wang L, et al. Circulating tumor DNA for MRD detection in colorectal cancer: recent advances and clinical implications. Biomarker Research. 2025;13:89. doi:https://doi.org/10.1186/s40364-025-00796-w
- Ryoo SB, Heo S, Lim Y, et al. Personalised circulating tumour DNA assay with large-scale mutation coverage for sensitive minimal residual disease detection in colorectal cancer. British Journal of Cancer. 2023;129(2):374-381. doi:https://doi.org/10.1038/s41416-023-02300-3
- Pyke RM, Dea S, El-Refai S, et al. Abstract 3845: Enhancing MRD detection through an ultrasensitive ctDNA test: insights from real-world clinical data. Cancer Research. 2026;86(7_Supplement):3845. doi:https://doi.org/10.1158/1538-7445.AM2026-3845
- Signatera advanced cancer detection: information for clinicians. Natera. Accessed Aug 31, 2026. https://www.natera.com/oncology/signatera-advanced-cancer-detection/clinicians/
- Muzzey D. Ultra-sensitive molecular residual disease detection with Myriad's Precise MRD test. Sponsored Industry Expert Theater presentation; ASCO Annual Meeting; 2026; Chicago, IL. Used with permission.
- Johnston AD, Ross JP, Ma C, et al. Epigenetic liquid biopsies for minimal residual disease, what's around the corner? Frontiers in Oncology. 2023;13:1103797. doi:https://doi.org/10.3389/fonc.2023.1103797
- Twist Bioscience. MRD Express product sheet.
