Eur J Cancer. 2025 Dec 9;231:116050. doi: 10.1016/j.ejca.2025.116050. Epub 2025 Oct 20.

ABSTRACT

BACKGROUND: Circulating tumor cells (CTCs) are a versatile biomarker in solid tumors. Extensive research supports their clinical relevance and led to regulatory approval in breast, prostate, and colorectal cancers. However, clinical adoption remains limited mainly due to the lack of consensus and standardized technologies. Additionally, CTC research lacks unified direction. To address these gaps, an international expert panel was established to assess the current and future clinical utility of CTCs.

METHODS: A panel of 11 CTC experts identified key areas of controversy, informing a structured survey distributed to 55 international multidisciplinary experts. Consensus was predefined as ≥ 70 % agreement. Areas without consensus were discussed in a virtual meeting, leading to final statements on the clinical integration of CTCs.

RESULTS: Thirty-seven experts completed the survey. Consensus was reached on the clinical utility of CTCs for prognosis and treatment monitoring in metastatic breast (BC) and prostate (PC) cancers, including AR-V7 testing in metastatic castration-resistant PC for therapy selection. In other tumors, CTCs remain investigational. Experts agreed that while clinical utility is not yet established in early-stage disease, CTCs show promise in early BC, especially combined with cell-free DNA (cfDNA) for minimal residual disease detection. CellSearch® is currently the only platform with high-level evidence for clinical use, though emerging technologies are promising. Key challenges include improving detection sensitivity/specificity, standardizing workflows, generating robust data, and clinician education. Experts emphasized shifting from enumeration to phenotypic and molecular characterization, particularly for treatment guidance, and highlighted the complementary role of CTCs and cfDNA, advocating for integrated liquid biopsy approaches.

CONCLUSIONS: This consensus offers practical guidance for clinical integration of CTCs and outlines strategic research priorities to unlock their full potential in precision oncology.

PMID:41172567 | DOI:10.1016/j.ejca.2025.116050

J Liq Biopsy. 2025 Aug 6;9:100320. doi: 10.1016/j.jlb.2025.100320. eCollection 2025 Sep.

ABSTRACT

Over the past decade, liquid biopsy has progressively expanded its role in oncology, supported by mounting evidence demonstrating an increasing number of clinical applications. At the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, liquid biopsy emerged as a central theme across multiple sessions, with more than 700 abstracts, investigating the clinical utility of liquid biopsy across a wide range of tumor types and disease stages. Applications presented included cancer screening, minimal residual disease (MRD) detection, management of metastatic disease, and potential use for matching patients to clinical trials. This editorial, authored on the behalf of the Young Committee of the International Society of Liquid Biopsy (ISLB) highlights the result of selected studies, grouped by tumor type.

PMID:40980343 | PMC:PMC12447415 | DOI:10.1016/j.jlb.2025.100320

Crit Rev Oncol Hematol. 2025 May 28;213:104776. doi: 10.1016/j.critrevonc.2025.104776. Online ahead of print.

ABSTRACT

Over the past decade, liquid biopsy (LB) has emerged as a key tool in oncology. Its utility in non-invasive sampling and real-time monitoring has made it a cornerstone in precision medicine. Since 2020, publications on LB in solid tumors have doubled, underscoring its pivotal role in advancing cancer care. Notably, 2024 marked a peak in scientific papers on this topic. Blood remained the most studied biofluid, with circulating tumor DNA (ctDNA) as the most frequently analyzed analyte, followed by circulating tumor cells, extracellular vesicles, and microRNAs. Among tumor types, gastrointestinal, lung, breast, and genitourinary cancers were the most investigated, collectively accounting for more than half of the studies. Early cancer and minimal residual disease detection are critical areas of interest, emphasizing the expanding potential of fragmentomics and methylation profiling, as well as the prognostic significance of ctDNA across various cancer types. Moreover, serial ctDNA monitoring demonstrated the ability to predict relapse and guide treatment (de)-escalation strategies. In metastatic setting, ctDNA profiling plays a crucial role in capturing tumor heterogeneity, detecting resistance mechanisms, and informing treatment selection. Non-blood biofluids gained interest for their potential to enhance the detection of clinically relevant alterations in different cancer types such as central nervous system and head and neck cancers. Other than biomarkers selection, the technological advancements and artificial intelligence significantly improved the sensitivity and specificity of LB assays. This evidence in combination with the rapid advancement of machine learning and other computational approaches, are paving the way for a new chapter of LB research.

PMID:40447209 | DOI:10.1016/j.critrevonc.2025.104776