CSF Sequencing Test Aligns with Updated Brain Tumor Guidelines

Accurate genomic characterization of central nervous system tumors can be challenging when surgery or stereotactic biopsy is not feasible because of tumor location, patient health, or surgical risk. In these scenarios, updated National Comprehensive Cancer Network (NCCN) Guidelines for Central Nervous System Cancers now expand sequencing recommendations to include cerebrospinal fluid (CSF) molecular profiling for inoperable high-grade gliomas and glioblastomas. To support this approach, a specialized CSF-based test now provides combined DNA and RNA analysis to help inform treatment planning.

Liquid Trace, developed by Genomic Testing Cooperative (GTC; Lake Forest, CA, USA), is a CSF-based molecular profiling service for patients whose tumor tissue is unavailable or insufficient. The service combines analysis of cell-free DNA (cfDNA) and RNA, and GTC is highlighting its applicability following the recent NCCN guideline update.

Liquid Trace evaluates cfDNA and RNA from CSF to help identify molecular abnormalities, support diagnosis, characterize the primary tumor, and assess disease biology. Because CSF directly bathes the central nervous system, it may be more informative than blood and may contain tumor-derived material that is not readily detected by cytology, the current standard of care. The test is optimized for primary and metastatic central nervous system neoplasms and also supports measurable residual disease (MRD) monitoring, therapy selection, and clinical trial matching.

Liquid Trace is used by leading cancer programs and academic medical centers nationwide. It is also the only commercially available CSF-based testing option with Medicare coverage for DNA analysis. The service aligns with guideline-driven sequencing when tissue biopsy cannot be performed.

“The NCCN update reinforces what clinicians and researchers have recognized: CSF can be an essential source of molecular information for patients with central nervous system tumors. For these patients, partial information is not enough,” said Maher Albitar, MD, GTC’s Chief Executive Officer and Chief Medical Officer.

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