Liquid Biopsy Reshapes Precision Medicine: Lori Brisbin, MS, MLS

Advances in circulating tumor DNA (ctDNA) testing and liquid biopsy technology are reshaping the landscape of precision oncology, offering new avenues to overcome longstanding barriers to equitable care, according to Lori Brisbin, MS, MLS, vice president of precision medicine for Texas Oncology and leader of Precision Health Informatics, the organization's data company.

Brisbin spoke on the panel, “Is Precision Medicine Making Cancer Care More or Less Equitable?” at The American Journal of Managed Care^®’s annual Patient-Centered Oncology Care® conference, held in Nashville, Tennessee, September 24-25, 2026.

Tissue Biopsy Challenges Drive Innovation

In an interview at the meeting, Brisbin identified tissue acquisition as one of the most persistent obstacles in precision medicine. Repeat biopsies present significant burdens for patients already navigating cancer treatment, particularly those with metastatic disease.

“If you can imagine, you're a lung cancer patient; you've already had a biopsy. Now we're metastatic lung, and we want to go back in and get another biopsy, which we want to look at the metastatic cancer,” she explained. “That's actually not only uncomfortable and inconvenient, but it also has some risk to it.”

For certain tumor types, tissue-based sampling is not merely inconvenient; it can be clinically infeasible. Brisbin pointed to prostate cancer that has metastasized to bone as a clear example, noting that “we can't get good biopsies out of the bone,” which makes liquid biopsy a critical alternative rather than a supplementary option.

Liquid Biopsy Expands Reach Across Diverse Populations

Laboratory partners have implemented at-home phlebotomy services to extend testing access across geographically and demographically diverse regions. Brisbin pointed to Texas Oncology's patient population, spanning urban and rural communities from El Paso to Amarillo to Dallas and Austin, as broadly representative of the national population. Through at-home blood draws, phlebotomists can collect samples directly from patients regardless of location, enabling liquid biopsy testing without requiring travel to specialized facilities.

Combined with ctDNA testing, Brisbin characterized this capability as transformative for precision medicine delivery, substantially reducing geographic and logistical barriers that have historically limited access to advanced diagnostic testing.

Despite these advances, she emphasized that tissue biopsy remains the preferred diagnostic standard. While liquid biopsy provides valuable and often necessary information, clinicians continue to prioritize tissue sampling when feasible, underscoring that ctDNA technology serves as a critical complement rather than a full replacement in the current precision medicine paradigm.