Liquid Biopsy in Thoracic Oncology: ctDNA & Multi-Analyte Platforms for Therapeutic Monitoring

Liquid biopsy has rapidly transformed thoracic oncology, moving from a baseline molecular profiling tool to a dynamic approach for longitudinal monitoring of treatment response. Circulating tumor DNA (ctDNA) has demonstrated strong potential for detecting minimal residual disease, guiding therapy adjustments, and identifying resistance mechanisms in non-small cell lung cancer and other thoracic malignancies. However, despite significant advances in analytical technologies, standardization across laboratories, robustness of assay validation, and clinical integration remain pressing challenges. The emergence of multi-analyte platforms—combining genomic, epigenomic, proteomic, and extracellular vesicle-derived signals—has expanded the horizon beyond single biomarkers, offering a more comprehensive view of tumor biology. Yet, questions persist around their reproducibility, regulatory readiness, and utility in informing real-world decision-making. A coordinated scientific effort is needed to connect technological innovation with clinical outcomes, ensuring that these approaches deliver meaningful benefits to patients.This Research Topic aims to gather pioneering studies that advance the development, validation, and clinical translation of ctDNA and multi-analyte liquid biopsy platforms for therapeutic monitoring in thoracic oncology. It seeks to address how molecular kinetics and analyte dynamics can inform real-time treatment adjustments, detect early recurrence, and monitor tumor evolution across therapy lines. The ultimate goal is to bridge assay development with precision clinical application—transforming sensitive molecular measurements into actionable guidance for therapy sequencing, resistance management, and therapeutic optimization.To gather further insights into liquid biopsy applications in thoracic oncology, we welcome articles addressing, but not limited to, the following themes:- Assay and platform development: analytical validation and clinical qualification of novel multi-analyte assays integrating genomics, epigenomics, proteomics, and extracellular vesicle profiling- Dynamic monitoring and surrogacy: ctDNA kinetics as predictive markers of response and potential surrogate endpoints, including pathological complete response in therapeutic trials- Tracking clonal evolution and resistance: longitudinal ctDNA analysis to identify emerging resistance mechanisms, such as secondary genomic alterations during targeted therapy or immunotherapy- Minimal residual disease (MRD): clinical validation of ctDNA-based MRD assays for recurrence risk assessment and personalized adjuvant strategies in early-stage cancers-Clinical translation and standardization: harmonization of workflows, cost-effectiveness, and regulatory considerations to implement multi-analyte liquid biopsy in routine thoracic oncology practice.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.Dr. Dall'Olio has received honoraria from Leo Pharma Grants from Fondation Gustave Roussy, Canceropole Ile de France, Ligue contre le Cancer.Dr. Marinello has received a research grant from Fondation ARC pour la Recherche sur le Cancer.Dr. Tagliamento has received honoraria for consulting from Oncotech, AstraZeneca, Pharmamar; personal honoraria (speaker bureau/advisory board) from Roche, Novartis, Takeda, Sandoz, AstraZeneca, Regeneron, MSD; non-personal financial support (travel-accommodation expenses) from Eli Lilly, Takeda, OSE Immunotherapeutics, Roche, Daiichi Sankyo, Johnson&Johnson; research grants (to their institution) from AIRC - Italian Association on Cancer Research, Pfizer. Topic editors: Arianna Marinello, Marco Tagliamento, Filippo Gustavo Dall'Olio Source: https://www.frontiersin.org/research-topics/84252/liquid-biopsy-in-thoracic-oncology-ctdna-multi-analyte-platforms-for-therapeutic-monitoring