Early multi-cancer detection using liquid biopsy: emerging biomarkers and clinical strategies

Liquid biopsy has become a revolutionary method for the early detection of cancer as a non-invasive technology that can assess circulating tumor material in biofluids. Liquid biopsy allows dynamic monitoring of tumor evolution, genetic changes and treatment responses, which is different from traditional tissue biopsy which offers a static and potentially narrow view of tumor biology. This mini-review will summarize the rapidly evolving future of circulating biomarkers (circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), microRNAs, proteins, exosomes and epigenetic fingerprints), with their potential for early multi-cancer biomarkers, and their integration into early detection. The analytical sensitivity of liquid biopsy has expanded dramatically through technologies such as next-generation sequencing (NGS), digital PCR, and advanced proteomics. In addition, data collection has been enhanced through machine learning for increased predictive performance and the identification of new biomarkers. This review discusses clinical performance between liquid and tissue biopsy and the value of combined biomarker methods to improve accuracy for the detection of early disease. Finally, future directions will be presented to identify new methods of integration, improved costs and the establishment of early detection programs at the population scale.