The Blood Profiling Atlas in Cancer Consortium (BloodPAC) published “Generic Protocols for the Analytical Validation of Next-Generation Sequencing-Based ctDNA Assays: A Joint Consensus Recommendation of the BloodPAC’s Analytical Variables Working Group.”1 Developed by consortium members, the resource serves as set of generic analytical protocols and helps to define industry standards in the development of liquid biopsy tests. The generic analytic validation protocols are intended to be the starting point for developers or manufacturers of next generation sequencing-based circulating tumor DNA (NGS-based ctDNA) diagnostic tests. Analytic validation is used to determine whether assays perform as intended, assessing the performance limits and overall robustness of the test. The FDA has asked BloodPAC to embark on a second phase to develop analytic validation protocols for assays designed to detect and monitor patient status post-treatment, when molecular residual disease (MRD) is present. “Liquid biopsy technology holds great promise in improving the outcomes of patients with cancer, but without a common ‘yardstick’ with which the FDA can measure analytical performance, real gains for patients will be slow to materialize,” says Jim Godsey, PhD, vice president of assay development at Illumina and co-chair of the BloodPAC Analytical Variables Working Group (BloodPAC AVWG). “These protocols establish a vital piece of infrastructure that will accelerate the development of new tools to improve cancer care and are the tangible fruit of collaboration across industry, academic researchers, and the FDA.” Validation of liquid biopsy poses unique challenges, largely due to the extremely small amount of target DNA or RNA being detected by a cell free assay, which may be as low as 2 to 3 molecules in each tube of blood. The publication contains four standard methods and 11 protocols providing guidance on different aspects of validation studies, including limits of detection, accuracy and contrived sample functional characterization. The protocols were developed with input from the FDA through the official presubmission process. “Given the potential utility of these assays for patients and clinical decision making, we can’t afford to have companies duplicating efforts or have the FDA encumbered by regulatory standards that are out of step with rapidly advancing technology,” says John Simmons, vice president of translational medicine at Personal Genome Diagnostics (PGDx) and BloodPAC scientific co-chair. “Aligning on gold standard processes will not only help regulators effectively review products for performance, but it will help assay developers create tests that hold up to the highest scientific standards and truly transform cancer care for patient benefit.” BloodPAC fosters collaboration among representatives from academia, private foundations, pharmaceutical companies, diagnostic companies, payer groups, and government agencies. “Those working to develop assays designed to detect and monitor circulating tumor DNA must overcome unique hurdles in order to deliver accurate results,” says Mickey Williams, PhD, director of the Molecular Characterization Laboratory at the Frederick National Laboratory for Cancer Research, who consulted with BloodPAC on the project. “The BloodPAC efforts have produced a thoughtful manuscript that ctDNA assay developers should read for helpful advice on assay analytical validation. The involvement of many diverse stakeholders in BloodPAC has added tremendous value to this effort.” The standardized practices, protocols and terminology for analytical validation are intended to support not only the pre-submission discussions between manufacturers and the FDA, but also discussions between assay developers and potential industry partners. “BloodPAC was formed to yield exactly this type of outcome,” says Lauren Leiman, executive director of BloodPAC. “These protocols define rigorous scientific standards for ctDNA assays and sets a common playing field that will accelerate the cycle of innovation – through development, approval and clinical use – to yield better outcomes for patients.” Reference 1. Godsey JH, Silvestro A, Barrett JC, et al. Generic protocols for the analytical validation of next-generation sequencing-based ctDNA assays: a joint consensus recommendation of the BloodPAC’s analytical variables working group. Clin Chem. 2020;66(9):1156-1166. doi:10.1093/clinchem/hvaa164.