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Liquid Biopsy in Modern Oncology: Advances, Challenges, and Future Perspectives in Early Cancer Detection, Minimal Residual Disease, and Dynamic Patient Monitoring

Curr Oncol Rep. 2026 May 23;28(1):59. doi: 10.1007/s11912-026-01799-y.

ABSTRACT

PURPOSE OF REVIEW: Liquid biopsy has emerged as a minimally invasive approach to overcome the limitations of tissue biopsy in oncology. This review aims to synthesize recent advances in its clinical applications, particularly in early cancer detection, therapeutic monitoring, and minimal residual disease (MRD), while discussing current challenges, regulatory perspectives, and future directions.

RECENT FINDINGS: Circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), extracellular vesicles, and epigenetic markers are the most extensively studied biomarkers, in which clinical trials such as TRACERx and DYNAMIC have demonstrated that ctDNA monitoring enables earlier detection of recurrence and guides adjuvant therapy decisions more precisely than standard imaging. Commercially validated assays, including Guardant360 CDx, FoundationOne Liquid CDx, and Epi proColon, have received regulatory approval, reflecting growing clinical adoption; however, limitations persist, including reduced sensitivity in low-tumor burden settings, technical variability between platforms, and the risk of false positives from clonal hematopoiesis. Ongoing research highlights the promise of multi-omic approaches and the integration of artificial intelligence to improve sensitivity, capture tumor heterogeneity, and provide predictive insights into treatment response and resistance. Liquid biopsy represents a paradigm shift in precision oncology by enabling real-time, longitudinal tumor profiling. Although significant barriers remain, such as cost, accessibility, and lack of standardization, technological innovations and large-scale validation studies are paving the way for its routine clinical integration.

PMID:42176138 | DOI:10.1007/s11912-026-01799-y

Microbiome in Gastrointestinal Tumors: Implications in Oncogenesis and Therapeutic Response : Microbiome in Gastrointestinal Tumors

Curr Oncol Rep. 2026 May 22;28(1):58. doi: 10.1007/s11912-026-01793-4.

ABSTRACT

PURPOSE OF REVIEW: To provide an updated overview of the role of the human microbiome in the initiation, progression, and therapeutic response of gastrointestinal tumors, emphasizing molecular, immunological, and metabolic mechanisms, as well as its potential as a target for novel therapeutic strategies.

RECENT FINDINGS: Emerging evidence demonstrates that microbiome dysbiosis contributes to carcinogenesis across gastrointestinal malignancies, including colorectal, gastric, hepatic, and pancreatic cancers. Microbial-derived metabolites, such as short-chain fatty acids and secondary bile acids, modulate key signaling pathways involved in cell proliferation, apoptosis, and genomic stability. In addition, the microbiome influences the tumor microenvironment and immune responses, shaping variability in treatment outcomes. Both preclinical and clinical studies have shown that microbiome composition affects the efficacy and toxicity of chemotherapy and immunotherapy. Notably, specific microbial signatures are being explored as non-invasive biomarkers for early detection and prognostic stratification, while microbiome modulation strategies, such as diet, probiotics, antibiotics, and fecal microbiota transplantation, have demonstrated potential to enhance therapeutic response. The bidirectional interaction between the microbiome and the host plays a central role in gastrointestinal tumorigenesis and treatment response. Although this field holds significant promise for precision oncology, its clinical translation remains limited by interindividual variability, methodological heterogeneity, and insufficient longitudinal evidence. Future efforts should focus on standardization, validation of microbiome-based biomarkers, and integration of multi-omics and artificial intelligence approaches to enable clinically actionable applications.

PMID:42171841 | DOI:10.1007/s11912-026-01793-4

Microbiome in Gastrointestinal Tumors: Implications in Oncogenesis and Therapeutic Response : Microbiome in Gastrointestinal Tumors

Curr Oncol Rep. 2026 May 22;28(1):58. doi: 10.1007/s11912-026-01793-4.

ABSTRACT

PURPOSE OF REVIEW: To provide an updated overview of the role of the human microbiome in the initiation, progression, and therapeutic response of gastrointestinal tumors, emphasizing molecular, immunological, and metabolic mechanisms, as well as its potential as a target for novel therapeutic strategies.

RECENT FINDINGS: Emerging evidence demonstrates that microbiome dysbiosis contributes to carcinogenesis across gastrointestinal malignancies, including colorectal, gastric, hepatic, and pancreatic cancers. Microbial-derived metabolites, such as short-chain fatty acids and secondary bile acids, modulate key signaling pathways involved in cell proliferation, apoptosis, and genomic stability. In addition, the microbiome influences the tumor microenvironment and immune responses, shaping variability in treatment outcomes. Both preclinical and clinical studies have shown that microbiome composition affects the efficacy and toxicity of chemotherapy and immunotherapy. Notably, specific microbial signatures are being explored as non-invasive biomarkers for early detection and prognostic stratification, while microbiome modulation strategies, such as diet, probiotics, antibiotics, and fecal microbiota transplantation, have demonstrated potential to enhance therapeutic response. The bidirectional interaction between the microbiome and the host plays a central role in gastrointestinal tumorigenesis and treatment response. Although this field holds significant promise for precision oncology, its clinical translation remains limited by interindividual variability, methodological heterogeneity, and insufficient longitudinal evidence. Future efforts should focus on standardization, validation of microbiome-based biomarkers, and integration of multi-omics and artificial intelligence approaches to enable clinically actionable applications.

PMID:42171841 | DOI:10.1007/s11912-026-01793-4

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