Transl Oncol. 2025 Nov;61:102519. doi: 10.1016/j.tranon.2025.102519. Epub 2025 Sep 6.

ABSTRACT

Liquid biopsies, particularly those involving circulating tumor DNA (ctDNA) from patient blood, have emerged as crucial and minimally invasive adjuncts to standard tissue-based testing. ctDNA testing enables the identification of actionable mutations for targeted therapy and can be routinely used when tissue samples are unavailable for genotyping. Compared to tissue-based testing, ctDNA testing has the advantages of capturing spatial or temporal genomic heterogeneity and facilitating repeated assessments. The utility of liquid biopsies extends to multiple clinical applications, including cancer diagnosis, treatment monitoring, and minimal residual disease (MRD) detection. Numerous clinical trials are currently evaluating treatment strategies using ctDNA testing. In particular, the implementation of adjuvant treatment escalation or de-escalation based on MRD detection could dramatically transform future approaches to solid tumor treatment. Various ctDNA assays have been developed, and it is important to understand their strengths and weaknesses for effective clinical applications. Furthermore, ctDNA testing faces several technical challenges, including low sensitivity in detecting copy number alterations and fusions, as well as the possibility of detecting mutations associated with clonal hematopoiesis of indeterminate potential. In this review, we comprehensively discuss the methodologies and recent advancements in cfDNA-based liquid biopsies for cancer patients, covering diagnosis, genomic profiling, and treatment monitoring. Furthermore, we explore clinical trial designs employing ctDNA testing and anticipate forthcoming changes in patient care.

PMID:40915174 | PMC:PMC12450568 | DOI:10.1016/j.tranon.2025.102519

Int J Biol Macromol. 2025 Sep 5;327(Pt 2):147473. doi: 10.1016/j.ijbiomac.2025.147473. Online ahead of print.

ABSTRACT

Osteosarcoma (OS), the most prevalent primary bone malignancy in adolescents, is characterized by aggressive progression and early metastasis. However, the epigenetic drivers of its metastatic heterogeneity remain poorly understood. Herein, we integrated bulk DNA methylation profiling and single-cell RNA sequencing (scRNA-seq) to elucidate the epigenetic mechanisms driving OS metastatic heterogeneity. Consensus clustering identified two methylation subtypes (K = 2) with distinct survival outcomes, where hypermethylated (MSO-high) tumors exhibited poor prognosis. Weighted gene co-expression network analysis (WGCNA) revealed methylation-associated modules enriched in metabolic and immune pathways, pinpointing key genes such as CAMK1G and SLC11A1. Single-cell profiling uncovered MSO-high myeloid cells associated with inflammatory and oxidative phosphorylation pathways, while MSO-high OS cells displayed transdifferentiation toward fibroblasts via pseudotime trajectories, remodeling the extracellular matrix (ECM) to facilitate lung metastasis. Conversely, MSO-low tumors activated HLA-B-mediated neutrophil-CD8+ T cell interactions, promoting lymphatic metastasis via CXCR4/CXCL12 signaling. Furthermore, functional validation using the DNA demethylating agent decitabine demonstrated reduced fibroblastic transdifferentiation and suppressed invasive capacity in MSO-high osteosarcoma cells, supporting the therapeutic potential of targeting methylation dysregulation. These findings establish a model where DNA methylation dictates metastatic phenotypes through differential tumor-stromal crosstalk, providing novel targets for epigenetic therapy to disrupt fibrotic-immune networks and metastatic colonization.

PMID:40915448 | DOI:10.1016/j.ijbiomac.2025.147473

bioRxiv [Preprint]. 2025 Aug 25:2025.08.21.671519. doi: 10.1101/2025.08.21.671519.

ABSTRACT

Lung cancer is the most common cause of cancer-related death worldwide. Recent advancements in targeted therapies and immunotherapies have achieved remarkable success. However, patient responses to treatments with lung cancer vary substantially. The mutation status of driver genes can direct personalized treatment, but their prognostic value and treatment efficacy are limited. In this study, we developed a statistical framework named Genomic Aberration-Derived Signature for Patient Stratification (GASPS) to characterize the transcriptomic deregulation of driver genomic aberrations and stratify patients. By applying GASPS to The Cancer Genome Atlas Lung Adenocarcinoma (TCGA-LUAD) data, we developed gene signatures for 38 driver genomic aberrations, including gene mutations, amplifications, and deletions. These signatures were applied to independent lung cancer transcriptomic datasets containing a total of 2,226 patient samples. Our results indicated that these driver gene signatures are much more prognostic than their corresponding genomic mutations. Interestingly, the two EGFR-related signatures characterizing EGFR mutation and amplification, respectively, exhibited contrasting associations with prognosis, treatment response, and immune infiltration in the tumor microenvironment. Moreover, the STK11 mutation signature, rather than the mutation status, was found to be predictive of the response and long-term benefit of patients treated with immune checkpoint blockade therapy in lung cancer. This framework is readily applicable to most cancer types using existing data to improve prognostic risk assessment and treatment efficacy by guiding personalized therapies.

PMID:40909579 | PMC:PMC12407784 | DOI:10.1101/2025.08.21.671519

bioRxiv [Preprint]. 2025 Aug 25:2025.08.21.671519. doi: 10.1101/2025.08.21.671519.

ABSTRACT

Lung cancer is the most common cause of cancer-related death worldwide. Recent advancements in targeted therapies and immunotherapies have achieved remarkable success. However, patient responses to treatments with lung cancer vary substantially. The mutation status of driver genes can direct personalized treatment, but their prognostic value and treatment efficacy are limited. In this study, we developed a statistical framework named Genomic Aberration-Derived Signature for Patient Stratification (GASPS) to characterize the transcriptomic deregulation of driver genomic aberrations and stratify patients. By applying GASPS to The Cancer Genome Atlas Lung Adenocarcinoma (TCGA-LUAD) data, we developed gene signatures for 38 driver genomic aberrations, including gene mutations, amplifications, and deletions. These signatures were applied to independent lung cancer transcriptomic datasets containing a total of 2,226 patient samples. Our results indicated that these driver gene signatures are much more prognostic than their corresponding genomic mutations. Interestingly, the two EGFR-related signatures characterizing EGFR mutation and amplification, respectively, exhibited contrasting associations with prognosis, treatment response, and immune infiltration in the tumor microenvironment. Moreover, the STK11 mutation signature, rather than the mutation status, was found to be predictive of the response and long-term benefit of patients treated with immune checkpoint blockade therapy in lung cancer. This framework is readily applicable to most cancer types using existing data to improve prognostic risk assessment and treatment efficacy by guiding personalized therapies.

PMID:40909579 | PMC:PMC12407784 | DOI:10.1101/2025.08.21.671519