{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T05:17:16Z","timestamp":1767244636213,"version":"3.48.0"},"reference-count":99,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100031019","name":"Canada\u2019s Digital Technology Supercluster","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100031019","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Project ACTT\u2014Access to Cancer Testing & Treatment in Response to COVID-19"},{"DOI":"10.13039\/100008207","name":"AstraZeneca Canada","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008207","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Project ACTT"},{"DOI":"10.13039\/100031019","name":"Canada\u2019s Digital Technology Supercluster","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100031019","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Personalized cancer treatment depends on the accurate and timely detection of the patient tumor variants. LBx enables minimally invasive tumor mutation profiling. We report results of a pan-Canadian LBx program for patients with advanced solid tumors. Plasma samples were tested at Imagia Canexia Health accredited laboratory using the clinically validated Follow It 38-gene panel. A proprietary platform was used to identify clinically relevant variants in the circulating tumor DNA and report results following accepted international guidelines on clinical significance. A total of 4229 eligible patients submitted samples for LBx testing, and reports for 97% of them were delivered within ~8 days. More than 80% of Canadian oncologists from &gt;150 institutions across 12 provinces (11% from rural centers) participated in the project. The patient cohort consisted mostly of advanced or metastatic lung, breast, and colon cancers. ctDNA mutations were detected in &gt;50% of cases, and clinical trials were recommended for 76% of all participants. Health economics modeling analysis found that Follow It\u00ae in combination with tissue biopsy was cost-saving and resulted in an additional 0.1138 QALYs gained relative to tissue biopsy alone. The successful pan-Canadian implementation of a cost-effective, robust LBx testing program demonstrated its sustained demand and feasibility, and its potential economic and health benefits.<\/jats:p>","DOI":"10.3390\/curroncol33010018","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:08:11Z","timestamp":1767190091000},"page":"18","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lessons from a National Liquid Biopsy Program to Provide Cancer Testing and Treatment for Patients with Advanced Solid Tumors"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9634-2678","authenticated-orcid":false,"given":"Anna","family":"Lapuk","sequence":"first","affiliation":[{"name":"Avitia Inc., Montreal, QC H2S 3H1, Canada"},{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin L. S.","family":"Furman","sequence":"additional","affiliation":[{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Feijao","sequence":"additional","affiliation":[{"name":"Avitia Inc., Montreal, QC H2S 3H1, Canada"},{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebru","family":"Baran","sequence":"additional","affiliation":[{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonal","family":"Brahmbhatt","sequence":"additional","affiliation":[{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Betty","family":"Chan","sequence":"additional","affiliation":[{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ka Mun","family":"Nip","sequence":"additional","affiliation":[{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Kense","sequence":"additional","affiliation":[{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda","family":"Murphy","sequence":"additional","affiliation":[{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Miller","sequence":"additional","affiliation":[{"name":"Avitia Inc., Montreal, QC H2S 3H1, Canada"},{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4945-5834","authenticated-orcid":false,"given":"Vincent","family":"Funari","sequence":"additional","affiliation":[{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicja","family":"Parker","sequence":"additional","affiliation":[{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa K.","family":"McConechy","sequence":"additional","affiliation":[{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaqil","family":"Kassam","sequence":"additional","affiliation":[{"name":"Stronach Regional Cancer Centre, Southlake Regional Health Centre, Newmarket, ON L3Y 2P9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arif A.","family":"Awan","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, Ottawa, ON K1Y 1J8, Canada"},{"name":"Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, Ottawa, ON K1H 8M5, Canada"},{"name":"Department of Anatomical Pathology, The Ottawa Hospital, Ottawa, ON K1H 7W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, The Ottawa Hospital, Ottawa, ON K1H 7W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5379-7621","authenticated-orcid":false,"given":"Daniel","family":"Breadner","sequence":"additional","affiliation":[{"name":"Verspeeten Family Cancer Centre, London Health Sciences Center, London, ON N6A 5W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3048-5124","authenticated-orcid":false,"given":"Barry D.","family":"Stein","sequence":"additional","affiliation":[{"name":"Colorectal Cancer Canada, Montreal, QC H3Z 2P9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David G.","family":"Huntsman","sequence":"additional","affiliation":[{"name":"Imagia Canexia Health, Vancouver, BC V6R 1P2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E615","DOI":"10.1503\/cmaj.240095","article-title":"Projected estimates of cancer in Canada in 2024","volume":"196","author":"Brenner","year":"2024","journal-title":"Can. 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