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Recent advances in liquid biopsy for precision oncology: emerging biomarkers and clinical applications in lung cancer

Future Oncol. 2025 Aug 5:1-19. doi: 10.1080/14796694.2025.2542051. Online ahead of print.

ABSTRACT

Lung Cancer (LC) remains the leading cause of cancer-related mortality. While Tissue Biopsy (TB) remains the gold standard for molecular profiling, its invasiveness and inability to provide real-time monitoring have led to the adoption of Liquid Biopsy (LB) as a minimally invasive alternative. By analyzing different circulating analytes such as cell-free DNA (cfDNA), circulating tumor DNA (ctDNA), Circulating Tumor Cells (CTCs), Extracellular Vesicles (EVs), and Tumor-Educated Platelets (TEPs), LB offers a dynamic approach to assessing tumor heterogeneity, Minimal Residual Disease (MRD), and treatment resistance. Recent clinical trials have underscored their role in guiding therapy decisions and monitoring treatment response. In early-stage disease, several Randomized Clinical Trials (RCTs) have shown that ctDNA clearance predicts survival benefits in patients receiving neoadjuvant or perioperative Immune Checkpoint Inhibitors (ICIs). Additionally, adjuvant RCTs have confirmed the ctDNA prognostic role in post-surgical relapse risk assessment. Despite its transformative potential, challenges such as assay standardization, sensitivity limitations in early-stage disease, and regulatory barriers remain. As ongoing research continues to validate its clinical utility, LB is poised to become an indispensable tool in the precision management of LC.

PMID:40762271 | DOI:10.1080/14796694.2025.2542051

Urinary Tumor DNA-based Liquid Biopsy in Bladder Cancer Management: A Systematic Review

Eur Urol Focus. 2025 Aug 1:S2405-4569(25)00178-6. doi: 10.1016/j.euf.2025.06.009. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Urinary tumor DNA (utDNA) has emerged as a promising biomarker in the care, diagnosis, early detection, recurrence monitoring, and prognosis of bladder cancer (BCa). Its noninvasive nature, ease of access, and cost effectiveness make it an attractive option for both patients and health care providers. This review describes the current state of utDNA as a marker of BCa.

METHODS: Articles published between 2015 and 2025 on current utDNA-based techniques in BCa were identified and analyzed for relevance and insight into utDNA research and usage.

KEY FINDINGS AND LIMITATIONS: Recent investigations underscore the noninvasiveness and superior tumor detection capabilities of utDNA, particularly in the detection of minimal residual disease. Moreover, utDNA provides actionable information, such as tumor grade and staging information, to support precise treatment decisions, including targeted immunotherapy regimens and bladder preservation strategies. Although utDNA has shown promising results in small studies, larger studies must be performed before it can be considered as a standard procedure in clinical practice.

CONCLUSIONS AND CLINICAL IMPLICATIONS: Urinary tumor DNA has demonstrated great potential to improve on most, if not all, stages of detection, treatment, and monitoring of BCa. By preserving the low cost and noninvasiveness of urine cytology, and by replacing its suboptimal accuracy with a precision rivaling and often exceeding cystoscopy and circulating tumor DNA-based methods, utDNA offers patients a more comfortable, repeatable, and accurate way of detecting BCa. With increased sensitivity and accuracy, everything from low-grade tumors to the earliest signs of recurrence can be detected more effectively, optimizing patient treatment courses and improving outcomes.

PMID:40753029 | DOI:10.1016/j.euf.2025.06.009

Circulating tumor cells: Blood-based detection, molecular biology, and clinical applications

Cancer Cell. 2025 Aug 11;43(8):1399-1422. doi: 10.1016/j.ccell.2025.07.008. Epub 2025 Jul 31.

ABSTRACT

Circulating tumor cells (CTCs) are cancer cells, shed from primary tumors or metastases into the bloodstream. The first non-invasive "liquid biopsy" for cancer monitoring, CTCs have been largely surpassed by circulating tumor DNA (ctDNA) for clinical applications, given the ease of DNA sequencing without specialized cell isolation methods. However, emerging rare cell capture technologies that can process larger blood volumes and enable advanced single-cell analyses may enhance the range and potential of CTC-based biomarkers. CTCs are increasingly valuable for assessing tumor heterogeneity, guiding protein biomarker-driven cancer immune therapies, and assessing heterogeneous drug resistance, as well as for detecting minimal disease. CTCs, thus, remain central to understanding cancer dissemination and are poised to offer complementary diagnostic roles in the application of minimally invasive liquid biopsies for cancer. Here, we review recent advances in the study of these rare circulating cancer cells and discuss current limitations and future directions.

PMID:40749671 | DOI:10.1016/j.ccell.2025.07.008

Myeloid-Derived Growth Factor-Regulated Oncogenesis in Lung Adenocarcinoma Is Associated with EGFR Status and Cancer Aggressiveness

J Proteome Res. 2025 Aug 2. doi: 10.1021/acs.jproteome.5c00385. Online ahead of print.

ABSTRACT

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors have transformed lung adenocarcinoma (LUAD) treatment in EGFR-mutant (MT) patients, but strategies targeting wild-type (WT) EGFR tumors remain necessary. This study analyzed a diverse LUAD patient cohort with EGFR mutation statuses and wild-type profiles for ALK and KRAS to identify stage-specific biomarkers. Using quantitative proteomics and multiomics, we discovered 21 dysregulated proteins in early-stage EGFR-WT LUAD, identifying myeloid-derived growth factor (MYDGF) as a key candidate biomarker. Elevated MYDGF levels in tissue (n = 117) and serum (n = 196) correlated significantly with cancer stage in EGFR-WT patients but not EGFR-MT cases. Notably, a higher tumor-to-normal MYDGF ratio predicted a favorable prognosis in early-stage EGFR-WT LUAD. Functional studies demonstrated that MYDGF exerts distinct roles in cell viability and migration depending on its cellular localization and the invasive potential of cancer cells. Specifically, secreted MYDGF promoted a protumorigenic phenotype, whereas excess intracellular MYDGF appeared to suppress the oncogenic capacity of aggressive cancer cells. MYDGF knockdown and subsequent proteomic analysis provided further insights into these context-dependent functions. These findings highlight EGFR status- and stage-specific proteomic profiles in LUAD, emphasizing the importance of context-dependent biomarker assessment for personalized treatment strategies.

PMID:40752010 | DOI:10.1021/acs.jproteome.5c00385

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