How modern molecular diagnostics is changing the face of cancer care

Cancer diagnostics is undergoing a profound transformation. It is no longer concerned solely with identifying what a tumour is, but is increasingly central to understanding disease drivers, monitoring tumour evolution, and informing clinical decision-making. In this article, Dr Konstantinos Nikopoulos, Clinical Laboratory Geneticist (Laboratory Medicine FAMH) at Unilabs’ molecular diagnostics laboratory, explores how integrated diagnostics—spanning tissue pathology; molecular profiling; non-invasive blood-based testing, such as liquid biopsy assays; hereditary cancer genetics; and AI-supported tools—are helping to reshape cancer care.

The evolving patient journey in oncology

Modern cancer care increasingly depends on a continuum of medical expertise tailored to support patients from diagnosis and treatment selection through to response assessment and long-term follow-up. Dr Nikopoulos says this shift is being shaped by the power of connected diagnostics at Unilabs. “By bringing together conventional and digital pathology, molecular diagnostics, medical genetics and counselling services, laboratory medicine, imaging, and AI-enabled tools, Unilabs can deliver a holistic diagnostic approach for oncology.”

He adds that, beyond clinical capability, this kind of model also has clear value for patients. When pathology, molecular diagnostics, genetics, imaging, and follow-up testing sit within the same ecosystem, it can help reduce fragmentation, improve continuity, and support faster clinical decision-making. “For patients navigating an already complex cancer journey, that joined-up approach has the potential to make care feel more coordinated, responsive, and easier to navigate.”

Moving beyond tumour identification

While histology and tissue-based molecular pathology continue to form the foundation of diagnosis and tumour characterisation, that foundation is now being strengthened by broader genomic profiling through next-generation sequencing, alongside the growing role of digital pathology and AI-supported interpretation.

Dr Nikopoulos says the key clinical questions facing diagnostics experts today have moved beyond ‘what is the tumour?’ to include ‘what is driving the tumour?’, ‘is the treatment working?’, ‘is resistance emerging?’, and ‘is the disease coming back?’ “Answering those questions well requires histopathology, molecular profiling, imaging, and longitudinal testing to work together. This integrated model is increasingly how Unilabs presents its oncology capability, particularly in Switzerland, where we combine laboratory medicine, pathology, genetics, and imaging within a 360° diagnostics model. Rather than serving as a single point of confirmation, diagnostics is becoming a continuous source of clinically relevant insight. To me, this is one of the defining shifts in modern oncology.”

The growing role of non-invasive molecular diagnostics

Non-invasive molecular modalities are becoming an increasingly important part of cancer diagnostics. Liquid biopsy approaches, in particular, extend the diagnostic pathway beyond the static snapshot provided by tissue analysis. It can offer clinically valuable information when tissue is limited, when repeat biopsy is impractical, or when disease evolution calls for a more dynamic view of the tumour. 

This area has already become an important part of Unilabs’ oncology diagnostics offering. In the company’s molecular diagnostics laboratory in Lausanne, the development of a liquid biopsy service has marked a significant milestone as the first of its kind within the Unilabs group, helping to bring non-invasive molecular diagnostics into routine clinical practice.

Dr Nikopoulos says the same shift can also be seen in the rise of tumour-informed longitudinal monitoring, including minimal residual disease (MRD) assays such as Signatera, and methylation-based non-invasive tests such as Bladder CARE, both offered by Unilabs in certain markets. “These tools are attractive because they address some of the most clinically relevant follow-up questions in oncology: is there molecular residual disease? Is the patient responding? Is relapse emerging before it becomes clinically obvious? The evidence base for circulating tumour DNA (ctDNA) assays continues to grow , especially in recurrence-risk and MRD settings.”

Building a diagnostics continuum

Dr Nikopoulos argues that the clinical value of emerging technologies like these depends on careful positioning, appropriate indication, and thoughtful integration into routine practice. “For me, innovation creates real value when it is translated into a robust, interpretable, and clinically relevant service. In that context, molecular diagnostics strengthens the wider oncology offering: imaging becomes more informative, pathology becomes more connected, genetics more actionable, and the laboratory becomes a genuine partner in clinical decision-making. In an increasingly complex oncology landscape, this kind of integration may prove to be one of the most important differentiators of all.”