GFCO national recommendations on the use of liquid biopsy for circulating tumor DNA analysis in oncology

The analysis of circulating tumor DNA (ctDNA) by liquid biopsy is a major advance in the management of patients with cancer, offering a minimally invasive method for detecting tumor genetic alterations and enabling personalized monitoring. Faced with complex technological challenges and the need for rigorous validation, the French-Speaking Group for Oncological Cytogenomics (GFCO) has established national consensus guidelines.

These guidelines, designed to govern ctDNA analysis, were developed using the Delphi consensus methodology. A questionnaire developed by a working group of eight biologists and two bioinformaticians was submitted to 55 French platforms specializing in liquid biopsy in oncology. A participation rate of 71% was achieved. Consensus was defined by an agreement threshold of at least 80%. A live discussion and voting session was held during the GFCO 2024 Days for items that did not initially reach this threshold.

The validated recommendations cover the pre-analytical, analytical, and post-analytical phases. In total, 37 recommendations with a consensus exceeding 80% were adopted.

These GFCO recommendations provide a standardized framework for the use of liquid biopsy in oncology in France. Regular updates will be necessary to adapt to the rapid evolution of the technology.

Published by Bulletin du cancer, 2026. The guideline itself is at the source linked here.

doi.org/10.1016/j.bulcan.2026.05.008