The growing field of liquid biopsy and its Snowball effect on reshaping cancer management

Abstract

Liquid biopsy (LB) has emerged as a transformative tool in oncology, providing a minimally invasive approach for tumor detection, molecular characterization, and real-time treatment monitoring. By analyzing circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), extracellular vesicles (EVs), and microRNA (miRNA), LB enables comprehensive tumor profiling without the need for traditional tissue biopsies. Over the past decade, research in this field has expanded exponentially, leading to the integration of LB into clinical practice for specific cancer types, including lung and breast cancer. In 2024, the Journal of Liquid Biopsy (JLB) published innovative studies exploring the latest advancements in LB technologies, biomarkers, and their applications for cancer detection, minimal residual disease (MRD) monitoring, and therapy response assessment. This review synthesizes recent findings on the role of LB in cancer treatment and monitoring across different biomarkers, with a particular focus on newly published studies and their context within translational research. Additionally, it highlights emerging techniques such as fragmentomics, artificial intelligence, and multiomics, paving the way for more precise, personalized treatment decisions. Despite these advancements, challenges remain in standardizing methodologies, optimizing clinical validation, and integrating LB into routine oncological workflows. This mini-review highlights the evolving landscape of LB research and its potential to revolutionize cancer diagnosis, treatment monitoring, and therapeutic decision-making, ushering in a new era of precision oncology.

Keywords: Circulating tumor DNA/ctDNA; Circulating tumor cells/CTCs; Liquid biopsy; MicroRNA/miRNA; Solid tumors.

Fig. 1

Evolution of liquid biopsy field in the last two decades. A) Summary of LB original articles on different topics B) Number of original articles on specific biomarkers C) Number of clinical trials using liquid biopsy opened by year. Abbreviations: LB, Liquid Biopsy; ctDNA, circulating tumor DNA; miRNAs, microRNA; CTCs, circulating tumor cells; EVs, extracellular vesicles.

Fig. 2

How liquid biopsy is revolutionizing the management of cancer patients Abbreviations: MRD, Minimal Residual Disease (Created in BioRender. https://BioRender.com/lxjfn00).