Liquid biopsy for early detection and monitoring of lung cancer: A systematic review and meta-analysis.

Abstract

e20019 Background: Lung cancer is among the most severe and lethal malignancies globally. Liquid biopsy, a non-invasive diagnostic method, employs circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), and extracellular vesicles (EVs) to identify and track tumor markers. This systematic review and meta-analysis sought to evaluate liquid biopsy's diagnostic accuracy and efficacy for lung cancer, using data from seven trials. Methods: Following PRISMA guidelines, a thorough search of the Cochrane Library, PubMed, and Embase produced observational studies and randomized controlled trials (RCTs) based on seven investigations published between 2015 and 2025. Data from the selected studies were evaluated to determine the sensitivity and specificity of liquid biopsy using ctDNA, CTCs, and EVs for lung cancer diagnosis. The investigation examined the possibility of liquid biopsy in assessing therapy responses. Results: The pooled sensitivity and specificity for ctDNA were 85% and 90%, respectively, indicating its superiority as a biomarker for diagnosing early-stage lung cancer. CTCs had sensitivity and specificity rates of 80% and 88%, respectively, while EVs displayed sensitivity and specificity rates of 78% and 86%. Moreover, variations in ctDNA levels were associated with tumor advancement and treatment effectiveness, exhibiting a concordance rate of 92% for assessing therapeutic responses. Conclusions: Liquid biopsy demonstrates significant diagnostic accuracy for the early diagnosis of lung cancer and the monitoring of treatment responses, highlighting its promise as a transformative instrument in clinical management. Nonetheless, challenges about test consistency and cost are unaddressed. Additional research is required to delineate the specific function of liquid biopsy in the diagnosis and therapy surveillance of lung cancer.