Circulating Tumor DNA in Solid Tumors: Clinical Applications and Future Directions

Over the past decade, circulating tumor DNA (ctDNA) has emerged as one of the most transformative biomarkers in oncology, offering unprecedented opportunities for minimally invasive cancer management. As tumor-derived genetic material present in the bloodstream, ctDNA enables a dynamic and real-time "liquid biopsy" that captures the evolving landscape of tumor biology, heterogeneity, and clonal evolution. Its clinical utility continues to expand across the spectrum of cancer care—including early detection, tumor molecular profiling, prognostication, assessment of minimal residual disease (MRD), monitoring response to therapy, and the early identification of resistance mechanisms.Recent advances in ctDNA technology and analytical sensitivity have fueled excitement about its integration into routine oncology practice. However, significant challenges remain. The optimization and standardization of pre-analytical protocols, improvement of detection sensitivity—particularly for early-stage disease and low-shedding tumors—and robust clinical validation across diverse solid tumor types remain urgent priorities. Addressing these hurdles is essential for translating ctDNA research breakthroughs into tangible benefit for patients.This Research Topic provides a timely and comprehensive platform to showcase innovative studies and reviews that elucidate the clinical and translational impact of ctDNA in solid tumors. We invite contributions that explore novel technical developments—such as ultra-sensitive detection methodologies, bioinformatics pipelines, and assay standardization—as well as real-world applications in various solid malignancies. Manuscripts focusing on comparative effectiveness, cost-utility, guideline development, and regulatory considerations are also encouraged.Key themes of this Research Topic include (but are not limited to):o Advances in ctDNA detection and analysis technologieso ctDNA in early cancer detection and screeningo Clinical utility of ctDNA for molecular profiling and guiding targeted therapieso Real-time monitoring of treatment response and emergence of resistanceo ctDNA for minimal residual disease (MRD) assessment and postoperative surveillanceo Integration of ctDNA with other liquid biopsy biomarkers (e.g., CTCs, exosomes)o Challenges of implementation: sensitivity, specificity, standardization, and clinical validationo Case series, clinical trials, and real-world evidence illustrating the impact of ctDNA on patient managemento Ethical, economic, and regulatory considerations in ctDNA adoptionBy bringing together original research articles, method papers, reviews, and perspectives, this Research Topic seeks to bridge the gap between technological innovation and clinical application. Our goal is to accelerate the translation of ctDNA insights into personalized cancer care, ultimately enhancing outcomes and quality of life for patients with solid tumors.Please note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent clinical or patient cohort, or biological validation in vitro or in vivo, which are not based on public databases) are not suitable for publication in this journal. Topic editors: Oriol Mirallas, Shane Stecklein, Zahi Mitri Source: https://www.frontiersin.org/research-topics/76822/circulating-tumor-dna-in-solid-tumors-clinical-applications-and-future-directions