Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Apr 29:8:100297.
doi: 10.1016/j.jlb.2025.100297. eCollection 2025 Jun.

Enhancing detection and monitoring of circulating tumor cells: Integrative approaches in liquid biopsy advances

Thanmayi Velpula  1 , Viswanath Buddolla  1
Affiliations
Review

Enhancing detection and monitoring of circulating tumor cells: Integrative approaches in liquid biopsy advances

Thanmayi Velpula et al. J Liq Biopsy. .

Abstract

Liquid biopsy offers a minimally invasive method for detecting and monitoring cancer, with key biomarkers including circulating tumor cells (CTCs), cell-free DNA (cfDNA), and extracellular vesicles (EVs). Among these, CTCs provide dynamic insights into tumor heterogeneity, metastatic potential, and therapeutic resistance through molecular profiling and single-cell analysis. This review examines recent advancements in technologies such as microfluidics, nanotechnology, and next-generation sequencing (NGS), which have improved the accuracy and clinical use of CTC detection. A comparative analysis of liquid biopsy techniques highlights the strengths and limitations of key platforms, including NGS, digital PCR (ddPCR), and quantitative PCR (qPCR), providing insights into diagnostic accuracy and clinical significance. Combining genomic, transcriptomic, and proteomic analyses with artificial intelligence (AI) tools has enhanced tumor profiling and supports personalized treatment decisions in precision oncology. Despite notable progress, issues like assay standardization, sample variability, regulatory complexity, and data integration still limit widespread clinical use. Future directions emphasize interdisciplinary innovation, clinical validation, and robust bioinformatics frameworks to facilitate the seamless incorporation of CTC-based liquid biopsy into standard oncology practice. Overcoming these challenges may allow liquid biopsy to become a standard tool for early cancer detection, ongoing monitoring, and individualized treatment.

Keywords: Cell-free DNA; Circulating tumor cells; Exosomes; Liquid biopsy; Nanotechnology; Next-generation sequencing.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Unique contributions and overlapping roles of CTCs, cfDNA, and EVs in cancer diagnostics.
Fig. 2
Fig. 2
Comprehensive workflow of integrated liquid biopsy techniques for cancer diagnostics and monitoring.
Fig. 3
Fig. 3
Comparative analysis of CTC detection methods: sensitivity, specificity, and clinical applicability.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Gerratana L., Davis A.A., Foffano L., Reduzzi C., Rossi T., Medford A.…Cristofanilli M. Integrating Machine Learning-Predicted Circulating Tumor Cells (CTCs) and circulating tumor DNA (ctDNA) in Metastatic Breast Cancer: a proof of principle study on endocrine resistance profiling. Cancer Lett. 2024 - PubMed
    1. Dai Y., He J., Zhou Y., Yu Y., Hui H., Guo L., Yin H. Constructing a highly sensitive duplex immunoassay using AuNPs and AgNPs as nanolabels for investigating the epithelial-mesenchymal transition occurring on circulating tumor cells with lung cancer patients. Biosens Bioelectron. 2025;270 - PubMed
    1. Miyamoto D.T., Sequist L.V., Lee R.J. Circulating tumour cells—monitoring treatment response in prostate cancer. Nat Rev Clin Oncol. 2014;11(7):401–412. - PubMed
    1. Viswanath B., Kim S. Recent insights into the development of nanotechnology to detect circulating tumor cells. TrAC, Trends Anal Chem. 2016;82:191–198.
    1. Thery L., Meddis A., Cabel L., Proudhon C., Latouche A., Pierga J.Y., Bidard F.C. Circulating tumor cells in early breast cancer. JNCI Cancer Spectr. 2019;3(2) - PMC - PubMed

LinkOut - more resources