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Minimal Residual Disease (MRD) testing is transforming how doctors detect, track, and treat cancer. What is minimal residual disease? It refers to the tiny number of cancer cells that remain after treatment often invisible with standard scans but capable of triggering relapse. With advanced methods like next-generation sequencing (NGS), digital PCR, and circulating tumor DNA (ctDNA) assays, minimal residual disease testing now gives a clearer picture of treatment response, disease progression, and long-term prognosis.
In 2025, Minimal Residual Disease testing has moved beyond research labs and into routine clinical care. The MRD test is gaining wider regulatory approvals, payer coverage, and deeper integration with hospital systems. Drug developers are also relying on MRD cancer testing as a faster, more reliable trial endpoint. With big strides in sensitivity and scalability, MRD testing is fast becoming a cornerstone of precision oncology, helping patients receive more personalized and timely care.
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1. Adaptive Biotechnologies
Adaptive’s FDA-cleared clonoSEQ test tracks residual cancer cells in myeloma, ALL, and CLL using NGS immunosequencing. Widely adopted with payer coverage, it provides reliable, standardized MRD monitoring and sets benchmarks for sensitivity, precision, and longitudinal patient management in hematologic oncology.
Advancement in 2025
2. Natera - Natera’s Signatera, a tumor-informed ctDNA assay, personalizes MRD detection across solid tumors. Widely covered by payers, it guides adjuvant therapy, recurrence monitoring, and trial endpoints, making Natera a leader in precision oncology surveillance.
Advancement in 2025
3. Guardant Health - Guardant Reveal, the first tumor-agnostic, tissue-free ctDNA MRD test, revolutionizes recurrence detection in colorectal and solid tumors. Its noninvasive, accessible approach accelerates integration into routine care, broadening adoption and improving earlier cancer intervention globally.
Advancement in 2025
4. Exact Sciences - Exact’s Haystack-powered ctDNA MRD assays focus on colorectal and multi-tumor recurrence monitoring. Complementing its screening portfolio, Exact extends precision oncology across the cancer continuum, offering early detection through recurrence tracking within an integrated ecosystem.
Advancement in 2025
5. Foundation Medicine (Roche) - FoundationOne Tracker pairs deep tissue CGP with a customized ctDNA assay for ongoing, patient-specific monitoring; a complementary tumor-naïve blood-only program supports serial response assessment when tissue isn’t practical.
Advancement in 2025
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6. Personalis - Personalis’ NeXT Personal delivers ppm-level MRD detection with ultra-deep sequencing. Its sensitivity supports earliest relapse detection, empowering oncologists and accelerating immuno-oncology trials, positioning Personalis as a leader in next-generation MRD precision monitoring solutions.
Advancement in 2025
7. NeoGenomics / Inivata - NeoGenomics’ RaDaR provides tumor-informed ctDNA MRD testing with high sensitivity across solid tumors. Integrated into diagnostic workflows, RaDaR strengthens recurrence monitoring, bridging molecular testing and pathology for routine clinical adoption of precision oncology.
Advancement in 2025
8. Sysmex Inostics - Sysmex’s OncoBEAM platform delivers plasma-based MRD detection using digital PCR and NGS. Its accessible, sensitive tools support hematologic and solid tumor monitoring, expanding global access to precision oncology with cost-efficient, rapid recurrence tracking solutions.
Advancement in 2025
9. Tempus - Tempus integrates MRD assays with its AI-driven clinico-genomic platform. Combining tumor-informed ctDNA with real-world data, Tempus personalizes treatment and optimizes trial design, embedding MRD testing into a continuous, data-powered oncology learning ecosystem.
Advancement in 2025
Advancement in 2025
Minimal Residual Disease (MRD) testing has evolved from a research tool into a frontline clinical standard in 2025. By detecting cancer at its most hidden levels, MRD tests are enabling doctors to deliver truly personalized treatment, predict relapse with higher accuracy, and improve patient outcomes. With leading companies driving innovation in minimal residual disease testing, the field is expanding rapidly covering more cancer types, gaining payer support, and becoming deeply embedded in routine oncology care. As technology continues to advance, MRD cancer testing will not just complement traditional scans but redefine the way cancer is monitored, treated, and ultimately defeated.
