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Clinical Management of Circulating Tumor DNA in Breast Cancer: Detection, Prediction, and Monitoring

2 October 2025 at 18:00

Breast Cancer (Dove Med Press). 2025 Sep 25;17:851-861. doi: 10.2147/BCTT.S542704. eCollection 2025.

ABSTRACT

Despite substantial progress in the diagnosis and treatment of breast cancer, current therapeutic regimens exhibit limitations, necessitating the identification of more robust biomarkers to optimize personalized strategies. Circulating tumor DNA (ctDNA), as a non-invasive liquid biopsy modality, overcomes the inherent constraints of biopsies in capturing tumor heterogeneity. Accumulating evidence from prospective cohort studies demonstrates the clinical utility of ctDNA in risk stratification, guidance of therapeutic decision-making, recurrence surveillance and other clinical applications. Furthermore, ctDNA profiling enhances real-time pharmacodynamic monitoring and accelerates drug development by identifying molecular responders. The methodical requirements and challenges inherent in implementing liquid biopsy assessments in the clinic are examined. These encompass critical pre-analytical variables, the need for highly sensitive and specific analytical techniques, standardization of assays and bioinformatics pipelines across laboratories and the complexities of interpreting results. This review synthesizes current evidence supporting ctDNA integration into breast cancer management frameworks and systematically addresses its methodological challenges and clinical limitations.

PMID:41036092 | PMC:PMC12479222 | DOI:10.2147/BCTT.S542704

WMRCA + : a weighted majority rule-based clustering method for cancer subtype prediction using metabolic gene sets

Hereditas. 2025 Jul 7;162(1):121. doi: 10.1186/s41065-025-00487-4.

ABSTRACT

Accurate classification of cancer subtypes plays a pivotal role in advancing precision medicine. In this study, we introduce WMRCA + , a novel clustering approach based on a weighted majority rule that integrates multi-omics data and incorporates metabolic gene sets to robustly determine the optimal number of clusters for tumor subtype identification. WMRCA + evaluates clustering performance using ten internal metrics and offers comprehensive functionalities for data preprocessing and visualization. When applied to The Cancer Genome Atlas (TCGA) lung cancer dataset using lipid metabolism-related gene sets, WMRCA + outperformed widely used clustering algorithms-including iCluster, SNF, NMF, CC, and CNMF-achieving an AUC of 0.947. WMRCA + provides robust, interpretable, and biologically meaningful clustering results, offering a valuable tool for improving the accuracy of cancer subtype prediction. The WMRCA + R package is freely available at https://github.com/guojunliu7/WMRCA .

PMID:40624602 | PMC:PMC12235908 | DOI:10.1186/s41065-025-00487-4

LcProt: Proteomics-based identification of plasma biomarkers for lung cancer multievent, a multicentre study

Clin Transl Med. 2025 Jan;15(1):e70160. doi: 10.1002/ctm2.70160.

ABSTRACT

BACKGROUND: Plasma protein has gained prominence in the non-invasive predicting of lung cancer. We utilised Zeolite Zotero NaY-based plasma proteomics to investigate its potential for multiple event predicting, including lung cancer diagnosis (task #1), lymph node metastasis detection (task #2) and tumour‒node‒metastasis (TNM) staging (task #3).

METHODS: A total of 4703 plasma proteins were quantified from 241 participants based on a prospective cohort of 2757 participants. An additional 46 participants from external prospective cohort of 735 participants were used for validation. Feature selection was performed using differential expressed protein analysis, area under curve (AUC) evaluation and least absolute shrinkage and selection operator (LASSO) regression. Random forest was used for multitask model construction based on the key proteins. Feature importance was interpreted using Shapley additive explanations (SHAP) algorithm.

RESULTS: For task #1, 10 proteins panel showed an AUC of .87 (.77‒.97) in the external validation. After integrating clinical factors, a significant increase diagnostic accuracy was observed with AUC of .91 (.85‒.98). For task #2, nine proteins panel achieved an AUC of .88 (.80‒.96), integration model showed an increase diagnostic accuracy with AUC of .90 (.85‒.97). For task #3, 10 proteins panel showed an AUC of .88 (.74‒.96) for stage I, .92 (.84‒.97) for stage II, .88 (.76‒.96) for stage III and .99 (.98‒.99) for stage IV in the integration model.

CONCLUSIONS: This study comprehensively profiled the NaY-based plasma proteome biomarker, laying the foundation for a high-performance blood test for predicting multiple events in lung cancer.

KEY POINTS: Our study developed an innovative nanomaterial, Zeolite NaY, which addressed the masking effect and improved the depth of the proteome. The performance of NaY-based plasma proteomics as a preclinical diagnostic tool was validated through both internal and external cohort. Furthermore, we explored the different patterns of plasma protein changes during the progression of lung cancer and used the explanations method to elucidate the roles of proteins in the multitask predictive model.

PMID:39783847 | PMC:PMC11714244 | DOI:10.1002/ctm2.70160

Genome-wide characterization of circulating metabolic biomarkers

Nature, Published online: 06 March 2024; doi:10.1038/s41586-024-07148-y

A meta-analysis of genome-wide association studies for 233 circulating metabolites from 33 cohorts reveals more than 400 loci and suggests probable causal genes, providing insights into metabolic pathways and disease aetiology.
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