Harnessing Liquid Biopsy to Transform Gynecologic Cancer Diagnosis and Treatment

A comprehensive review published in the Journal of Experimental & Clinical Cancer Research highlights the transformative potential of liquid biopsy in gynecologic oncology. Led by Professor Antonio Giordano of the Sbarro Health Research Organization, the study explores how minimally invasive blood-based diagnostics can enhance early detection, monitoring, and personalized therapy for women with endometrial, cervical, and ovarian cancers.

Liquid biopsy involves analyzing circulating tumor DNA (ctDNA), tumor-educated platelets, microRNAs, and extracellular vesicles found in bodily fluids such as blood, urine, saliva, or stool. These molecular markers provide real-time insights into tumor biology, overcoming many limitations of traditional tissue biopsies, particularly their invasiveness and challenges in accessing certain tumor sites.

The review rigorously outlines a translational framework that maps fourteen critical research domains — including assay development, biomarker validation, clinical endpoints, and cost-effectiveness — with an emphasis on integrating these biomarkers into routine clinical practice. This approach aims to establish standardized, reliable testing methods that can be widely adopted.

Liquid biopsy extends beyond biomarker detection; it acts as a bridge linking molecular biology with patient-centered care. Its noninvasive, repeatable nature allows for ongoing tumor monitoring, early detection of recurrence, and assessment of treatment responses, especially in cases where traditional imaging and biopsy are limited. This is particularly vital in gynecological cancers with heterogeneous presentations and anatomical challenges.

In ovarian cancer, liquid biopsy shows up to 90% specificity and increasing sensitivity when combining microRNA panels with ctDNA analysis, aiding early-stage detection. For endometrial cancer, personalized ctDNA profiles have demonstrated over 87% concordance with tissue-based classifications and can predict recurrence months before clinical symptoms appear. In cervical cancer, circulating HPV DNA and serum proteins like SCC-Ag and VCAM-1 correlate significantly with prognosis and therapy response, supporting the role of plasma-based surveillance. Furthermore, ctDNA profiling assists in detecting chemotherapy resistance, especially in BRCA-mutated tumors treated with PARP inhibitors.

Despite its promising outlook, the authors emphasize that liquid biopsy remains underutilized in clinical settings. They advocate for overcoming barriers such as the lack of FDA-approved multi-analyte assays, the need for standardized sample processing, and integrating artificial intelligence for data interpretation. The review calls for robust clinical trials, particularly in early-stage disease and population screening, incorporating emerging technologies like fragmentomics, methylomics, and machine learning to refine diagnostic accuracy.

Professor Giordano underscores that liquid biopsy has the potential to revolutionize gynecologic cancer care by enabling precise, real-time insights into tumor dynamics without invasive procedures. This advancement could lead to earlier diagnoses, more tailored treatments, and ultimately improved survival outcomes for millions of women worldwide.

Source: https://medicalxpress.com/news/2025-05-power-liquid-biopsy-clinical-gynecologic.html