Skip to content
DraconiticResearch
Search Sources API
203,234 studies31 sourcesUpdated 43 min ago
Peer-reviewedCC BYCancers

The Dynamic Role of Liquid Biopsy in Patients with Non-Small Cell Lung Cancer Receiving Immune Checkpoint Inhibitors: Emerging Opportunities and Clinical Challenges

  • Tancredi Didier Bazan Russo1,2
  • Valerio Gristina1
  • Francesco Pepe3
  • Claudia Scimone3
  • Giulia Busuito1
  • Domenico Cozzolino3
  • Claudia Sarracino3
  • Giuseppina Ratto3
  • Lorena Incorvaia1
  • Nadia Barraco1
  • Giuseppe Badalamenti1
  • Antonio Galvano1
4 more authors
  • Viviana Bazan4
  • Antonio Russo1
  • Giancarlo Troncone3
  • Umberto Malapelle3
4 affiliations
  1. 1Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, 90127 Palermo, Italy
  2. 2Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH 43210, USA
  3. 3Department of Public Health, University of Naples Federico II, 80131 Naples, Italy
  4. 4Department of Biomedicine, Neuroscience and Advanced Diagnostic (Bi.N.D.), University of Palermo, 90127 Palermo, Italy
Read full textPDFDOICite

Abstract

Immune checkpoint inhibitors (ICIs) have transformed the treatment of non-small-cell lung cancer (NSCLC), yet predicting durable benefit and detecting resistance remain major challenges. As immunotherapy expands across disease stages, minimally invasive tools are increasingly needed to monitor response and inform treatment personalization. Liquid biopsy enables serial assessment of circulating tumor DNA (ctDNA) and other blood-based biomarkers, complementing tissue analysis and imaging. This review critically synthesizes evidence across resectable, locally advanced, and metastatic NSCLC, integrating ctDNA dynamics with emerging multi-omics approaches. Its contribution is to distinguish the prognostic value of circulating biomarkers from evidence that using them to guide treatment improves patient outcomes, while identifying priorities for clinical translation. Across the reviewed studies, ctDNA clearance is associated with favorable outcomes, whereas persistent or rising ctDNA signals an increased risk of recurrence or progression, sometimes before radiological detection. Methylation, fragmentomics, plasma proteomics, and immune-cell profiling may provide complementary information on tumor-immune interactions. However, low tumor shedding, clonal hematopoiesis, assay variability, and unvalidated intervention thresholds limit routine use. The expansion of perioperative immunotherapy and emerging interest in biomarker-guided treatment adaptation make this synthesis timely. Prospective interventional trials are needed to determine whether liquid biopsy can safely guide treatment escalation, de-escalation, or discontinuation. By clarifying both the promise and the limitations of longitudinal monitoring, this review informs research aimed at detecting ineffective treatment earlier and reducing unnecessary treatment exposure while preserving cancer control.

Related

  1. Association of pre-existing cardiovascular disease with cardiovascular and clinical outcomes in patients receiving immune checkpoint inhibitors
    Lama Alfehaid, Ahmed S. Alanazi, Mansour Alomran +2
    Scientific ReportsPeer-reviewedCC BY-NC-ND 4.0Full textOncologyCrossref
  2. Risk of de novo immune-related adverse events in patients with cancer and autoimmune disease receiving immune checkpoint inhibitors
    Rotana M. Radwan, Grant D. Scheiffele, Wenxi Huang +9
    Communications MedicinePeer-reviewedCC BY 4.0General medicineNatureCrossref
  3. Intracranial Hemorrhage in Patients Receiving Factor Xa Inhibitors: Challenges and Perspectives
    Ryuki Chatani
    Internal MedicinePeer-reviewedCC BY-NC-NDFull textCardiovascular medicineJ-STAGE
  4. High-Sensitivity Cardiac Troponin T and I Discordance in Patients Receiving Immune Checkpoint Inhibitors
    Anis Ismail, Alexi Vasbinder, Bobby Bobby +14
    JACC: CardioOncologyPeer-reviewedCC BY 4.0Full text1 citedCardiovascular medicinePMCEurope PMC
  5. Distinct changes in plasma protein profiles of cancer patients receiving immune checkpoint inhibitors versus chemotherapy: implications for thrombosis risk and adverse outcomes
    Eleonora Camilleri, Nikola Vladic, Cornelia Englisch +10
    Research and Practice in Thrombosis and HaemostasisPeer-reviewedCC BYFull textOncologyDOAJ

Cite

BibTeXRIS
BibTeX
@article{russo2026dynamic,
  title = {{The Dynamic Role of Liquid Biopsy in Patients with Non-Small Cell Lung Cancer Receiving Immune Checkpoint Inhibitors: Emerging Opportunities and Clinical Challenges}},
  author = {Tancredi Didier Bazan Russo and Valerio Gristina and Francesco Pepe and Claudia Scimone and Giulia Busuito and Domenico Cozzolino and Claudia Sarracino and Giuseppina Ratto and Lorena Incorvaia and Nadia Barraco and Giuseppe Badalamenti and Antonio Galvano and Viviana Bazan and Antonio Russo and Giancarlo Troncone and Umberto Malapelle},
  journal = {Cancers},
  year = {2026},
  month = oct,
  doi = {10.3390/cancers18193240},
  url = {https://europepmc.org/article/PMC/PMC13664402},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - The Dynamic Role of Liquid Biopsy in Patients with Non-Small Cell Lung Cancer Receiving Immune Checkpoint Inhibitors: Emerging Opportunities and Clinical Challenges
AU  - Tancredi Didier Bazan Russo
AU  - Valerio Gristina
AU  - Francesco Pepe
AU  - Claudia Scimone
AU  - Giulia Busuito
AU  - Domenico Cozzolino
AU  - Claudia Sarracino
AU  - Giuseppina Ratto
AU  - Lorena Incorvaia
AU  - Nadia Barraco
AU  - Giuseppe Badalamenti
AU  - Antonio Galvano
AU  - Viviana Bazan
AU  - Antonio Russo
AU  - Giancarlo Troncone
AU  - Umberto Malapelle
PY  - 2026
DA  - 2026/10/01
JO  - Cancers
DO  - 10.3390/cancers18193240
UR  - https://europepmc.org/article/PMC/PMC13664402
AB  - Immune checkpoint inhibitors (ICIs) have transformed the treatment of non-small-cell lung cancer (NSCLC), yet predicting durable benefit and detecting resistance remain major challenges. As immunotherapy expands across disease stages, minimally invasive tools are increasingly needed to monitor response and inform treatment personalization. Liquid biopsy enables serial assessment of circulating tumor DNA (ctDNA) and other blood-based biomarkers, complementing tissue analysis and imaging. This review critically synthesizes evidence across resectable, locally advanced, and metastatic NSCLC, integrating ctDNA dynamics with emerging multi-omics approaches. Its contribution is to distinguish the prognostic value of circulating biomarkers from evidence that using them to guide treatment improves patient outcomes, while identifying priorities for clinical translation. Across the reviewed studies, ctDNA clearance is associated with favorable outcomes, whereas persistent or rising ctDNA signals an increased risk of recurrence or progression, sometimes before radiological detection. Methylation, fragmentomics, plasma proteomics, and immune-cell profiling may provide complementary information on tumor-immune interactions. However, low tumor shedding, clonal hematopoiesis, assay variability, and unvalidated intervention thresholds limit routine use. The expansion of perioperative immunotherapy and emerging interest in biomarker-guided treatment adaptation make this synthesis timely. Prospective interventional trials are needed to determine whether liquid biopsy can safely guide treatment escalation, de-escalation, or discontinuation. By clarifying both the promise and the limitations of longitudinal monitoring, this review informs research aimed at detecting ineffective treatment earlier and reducing unnecessary treatment exposure while preserving cancer control.
SN  - 2072-6694
ER  -