Current Advances of Molecular Biomarkers and Liquid Biopsies Techniques in Ovarian Cancer

Ovarian cancer (OC) remains a lethal gynecological malignancy with challenges in early diagnosis, treatment monitoring, and overcoming drug resistance. Liquid biopsy, a noninvasive approach analyzing tumor-derived components in bodily fluids, has emerged as a promising tool in OC management. This review summarizes advances in liquid biopsy technologies, focusing on circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs). ctDNA enables minimally invasive assessment for diagnosis, prognosis, treatment guidance (e.g., BRCA1/2-targeted therapy), minimal residual disease (MRD) detection, and monitoring of tumor evolution. CTCs, particularly clusters, provide insights into metastasis and therapeutic response. Emerging modalities such as tumor-educated platelets (TEPs), circular RNAs (circRNAs), and exosomes and protease activity-based liquid biopsy also show diagnostic and prognostic potential. Despite technical challenges like standardization and sensitivity, liquid biopsy holds significant promise for personalized OC care, with ongoing efforts to translate these technologies into clinical practice.