Liquid biopsy in precision oncology: from biological basis to clinical translation across the cancer continuum
Year: 2026
Type: article
Abstract: Liquid biopsy is transforming precision oncology by providing a minimally invasive alternative to conventional tissue biopsy. Tissue biopsies have important limitations, including invasiveness, sampling bias, and an inability to fully capture tumor heterogeneity. Given the urgent need for improved cancer diagnostics, as reflected by approximately 20 million new cancer cases and 9.7 million deaths in 2022, liquid biopsy represents a critical advance. This approach analyzes tumor-derived components in blood and other body fluids, including circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), extracellular vesicles (EVs), noncoding RNAs (ncRNAs), and tumor-educated platelets (TEPs). This review examines the biological origins of liquid biopsy analytes, advanced detection platforms droplet digital polymerase chain reaction (ddPCR), next-generation sequencing, epigenomic profiling, microfluidics, and artificial intelligence (AI)-driven integration), and the expanding clinical evidence base. Key applications include multi-cancer early detection (MCED), minimal residual disease (MRD) monitoring, treatment response assessment, resistance profiling, and characterization of tumor heterogeneity. We appraise landmark studies, including PATHFINDER 2 [European Society for Medical Oncology (ESMO) 2025], DYNAMIC (Nature Medicine 2025), and GALAXY (Nature Medicine 2024). Current challenges include low levels of ctDNA shedding, interference from clonal hematopoiesis, and preanalytical variability. Future directions include multi-omic integration and federated artificial intelligence. Liquid biopsy is poised to transform cancer screening, surveillance, and treatment stratification.
Source: Oncology in Clinical Practice
DOI: 10.5603/ocp.113556
Authors: Anup Chaudhary, Ajina Kafle, Roji Raut
Institutions: Purbanchal University, Center for Molecular Dynamics - Nepal
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W7171813402