Liquid Biopsy in Precision Oncology: Expanding Clinical Applications for Molecular Characterization, Disease Monitoring, and Personalized Management of Solid Tumors
Jul 2026· International science journal· 0 citations· 10 references
TL;DR
Overall, liquid biopsy represents a transformative strategy that complements conventional tissue biopsy and supports more personalized, dynamic, and evidence-based management of solid tumors.
Abstract
Liquid biopsy has rapidly emerged as one of the most promising innovations in precision oncology by providing minimally invasive access to tumor-derived biomarkers throughout the clinical course of cancer. This review analyzes the current evidence regarding the clinical applications of liquid biopsy beyond early cancer detection, emphasizing its role in molecular profiling, therapeutic selection, treatment monitoring, minimal residual disease assessment, identification of resistance mechanisms, and evaluation of tumor heterogeneity in patients with solid tumors. A comprehensive literature review was conducted using major biomedical databases, selecting high-quality publications focused on circulating tumor DNA, circulating tumor cells, extracellular vesicles, circulating RNA, and other emerging biomarkers. The available evidence demonstrates that circulating tumor DNA currently represents the most clinically validated biomarker because of its high analytical performance and increasing incorporation into precision oncology protocols. Liquid biopsy has shown particular utility in lung, colorectal, breast, and prostate cancers, where molecular information directly contributes to personalized treatment decisions. Nevertheless, several barriers continue to limit universal implementation, including high costs, limited molecular infrastructure, methodological variability, and unequal access to advanced genomic technologies, particularly in developing countries. Ongoing technological improvements, international collaboration, and methodological standardization are expected to further expand the clinical applications of liquid biopsy and facilitate its incorporation into routine oncology practice. Overall, liquid biopsy represents a transformative strategy that complements conventional tissue biopsy and supports more personalized, dynamic, and evidence-based management of solid tumors.
This review provides a comprehensive overview of the key analytes employed in liquid biopsy, including circulating tumor DNA, circulating tumor cells, microRNAs, extracellular vesicles, and protein biomarkers with particular emphasis on their translational relevance in breast cancer.
Pritam Saha Podder, Debasree Bhadra, Canio Martinelli et al.· Exploration of Targeted Anti...· 0 citations
Breast cancer remains the most frequently diagnosed cancer and a leading cause of cancer-related mortality among women worldwide, underscoring the need for accurate, minimally invasive biomarkers to support precision oncology. Conventional tissue biopsy remains the standard for molecular characterization but is limited by its invasiveness, inability to capture spatial and temporal tumor heterogeneity, and challenges in serial monitoring. Circulating tumor DNA (ctDNA), a tumor-derived fraction of cell-free DNA, has emerged as a promising liquid biopsy biomarker capable of providing real-time genomic information throughout disease progression. This narrative review examines recent advances in ctDNA biology, analytical technologies, clinical applications, current limitations, and future directions in breast cancer management. A structured literature search of PubMed/MEDLINE, Scopus, Embase, Web of Science, and Google Scholar identified relevant English-language publications from 2015 to 2026. Current evidence indicates that highly sensitive platforms, including digital PCR, BEAMing, and next-generation sequencing, can detect clinically actionable alterations in genes such as PIK3CA, ESR1, TP53, ERBB2, AKT1, and BRCA1/2. ctDNA has demonstrated particular utility in identifying minimal residual disease, monitoring therapeutic response, detecting emerging resistance mechanisms, and guiding targeted treatment selection in advanced breast cancer. However, applications in early cancer detection, population screening, and artificial intelligence-assisted clinical decision-making remain investigational. Widespread clinical implementation is constrained by low ctDNA abundance in early-stage disease, analytical variability, limited assay standardization, and cost considerations. Continued technological innovation, prospective multicenter validation, standardized testing protocols, and evidence-based clinical guidelines are essential to fully integrate ctDNA into routine precision breast cancer care.
E. I. Obeagu, C. Okafor· Breast Cancer: Basic and Cli...· 0 citations
Background
Glioblastoma (GBM) is the most aggressive primary malignant brain tumor in adults and is characterized by extensive
molecular and spatial heterogeneity, diffuse infiltration, and frequent recurrence. Current diagnosis and disease monitoring
rely primarily on tissue pathology and magnetic resonance imaging (MRI). However, tissue sampling is invasive and may
not fully capture the heterogeneous and evolving molecular landscape of the tumor, while MRI may have difficulty
distinguishing recurrent disease from treatment-related changes. Liquid biopsy has emerged as a minimally invasive
approach for detecting tumor-derived material in biological fluids and may provide opportunities for repeated molecular
assessment throughout the disease course.
Objective
This narrative review summarizes the current evidence regarding liquid biopsy in glioblastoma, with emphasis on
circulating tumor DNA, cell-free DNA, circulating tumor cells, microRNAs, extracellular vesicles, and other circulating
biomarkers. It further examines their potential applications in molecular characterization, diagnosis, prognostic assessment,
treatment-response monitoring, and detection of recurrence.
Methods
A narrative literature review was conducted using PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar.
Literature addressing glioblastoma, liquid biopsy, circulating tumor DNA, cell-free DNA, circulating tumor cells,
microRNAs, extracellular vesicles, exosomes, cerebrospinal fluid biomarkers, treatment monitoring, and recurrence was
identified and critically synthesized. Original research studies, systematic reviews, meta-analyses, and relevant
contemporary reviews were considered. Particular attention was given to evidence regarding blood- and cerebrospinal-fluidderived biomarkers and their potential clinical applications.
Results
Current evidence indicates that liquid biopsy may provide minimally invasive molecular and longitudinal information
in patients with glioblastoma. Circulating tumor DNA and cell-free DNA have been investigated for detection of tumorassociated genetic and epigenetic alterations, while circulating tumor cells, microRNAs, and extracellular vesicles represent
additional potential sources of diagnostic and prognostic information. Cerebrospinal fluid may provide greater detectability
of tumor-derived material than peripheral blood in selected patients, whereas blood-based approaches offer advantages for
repeated and less invasive sampling. Emerging studies also suggest potential applications in monitoring treatment response,
tumor evolution, and recurrence. Nevertheless, clinical implementation remains constrained by low circulating tumor
fractions, the blood–brain barrier, tumor heterogeneity, methodological variability, and limited prospective validation.
Conclusion
Liquid biopsy represents a promising complementary approach to conventional tissue pathology and neuroimaging in
glioblastoma. Its greatest future value may lie in longitudinal molecular monitoring and integration with MRI, radiomics,
artificial intelligence, and other molecular profiling approaches. Standardization of analytical methods and prospective
multicenter validation will be necessary before liquid biopsy can be routinely incorporated into clinical practice.
Usha Topalkatti, Jhansi Mani Mahadeva· International Journal of Inn...· 0 citations
Pancreatic ductal adenocarcinoma (PDAC) remains a major clinical challenge because reliable biomarkers for early detection, risk stratification, and treatment monitoring are still limited. Liquid biopsy has emerged as a promising complementary approach that enables minimally invasive assessment of tumor-derived material in body fluids. This review focuses on three selected and widely investigated liquid-biopsy biomarker classes in PDAC—ctDNA, CTCs, and exosome-derived biomarkers—because they map onto complementary molecular, cellular, and extracellular-vesicle compartments and have been evaluated across clinically relevant settings including diagnosis, prognosis, treatment monitoring, and minimal residual disease (MRD) assessment. We summarize their biological basis, detection strategies, and clinical applications in early detection, prognostic assessment, treatment monitoring, and minimal residual disease (MRD) evaluation. We also discuss assay selection in KRAS-wild-type disease, factors influencing ctDNA shedding, postoperative sampling timing, and the contribution of anatomically enriched body fluids such as bile and pancreatic juice. Current evidence indicates that ctDNA is the most mature platform for molecular profiling, prognostic assessment, treatment monitoring, and MRD research, although sensitivity remains limited in localized disease. CTCs provide intact cellular information and may offer prognostic value, but their rarity in peripheral blood and methodological heterogeneity limit routine use. Exosome-derived biomarkers are abundant and relatively stable, making them attractive for multiparametric diagnostic and prognostic models, although tumor specificity, isolation methods, and assay standardization remain substantial challenges. Overall, no single liquid-biopsy platform is sufficient for all PDAC scenarios. Future progress will require standardized methods, prospective clinical validation, and integrated biomarker strategies combined with established clinical parameters.
Lin Mi, Yan-Xiong Wang, Hai-Bo Xu et al.· Discover Oncology· 0 citations
Liquid biopsy has emerged as a powerful non-invasive tool in precision oncology, providing real-time insights into tumor evolution, host immune responses, and dynamic changes in the tumor immune microenvironment. By enabling minimally invasive sampling, it can overcome several limitations of conventional tissue biopsy. This review summarizes the major biological sources and components of liquid biopsy, including circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), exosomes, and circulating immune cells, and discusses their value as dynamic indicators of interactions during cancer immunotherapy. Particular attention is given to immune-related biomarkers associated with immune checkpoints, immunosuppressive mechanisms, and immune escape, including circulating immune cell populations, and inflammatory cytokine profiles. We further examine their potential applications in predicting treatment response, monitoring immune-related adverse events, assessing minimal residual disease, and detecting acquired resistance. In addition, recent technological advances that are accelerating the clinical translation of liquid biopsy are highlighted, including multi-omics integration, microfluidic platforms. These approaches have improved the sensitivity, accuracy, and multidimensional characterization of tumor- and immune-derived biomarkers. Nevertheless, biological heterogeneity, limited assay standardization, and the lack of large-scale prospective validation studies continue to restrict widespread clinical implementation. Overall, immune-related biomarkers detected through liquid biopsy offer considerable potential for the longitudinal monitoring of the tumor immune microenvironment and may improve non-invasive cancer diagnosis, therapeutic monitoring, and personalized immunotherapy in the era of precision oncology.
Lai Wen, Xin-Hui Wang, Jin-Ming Liu et al.· Frontiers in Cell and Develo...· 0 citations
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