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Circulating tumor DNA (ctDNA) obtained through liquid biopsy offers a less invasive approach than tissue sampling, enabling repeated longitudinal assessment of tumor burden and molecular evolution. ctDNA is linked to prognosis across disease stages, with reviewed evidence supporting roles in early diagnosis, minimal residual disease detection after curative surgery, and treatment monitoring in advanced settings.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/circulating-tumor-dna-in-gastric-adenocarcinoma-future-clinical-applications-and-perspectives/376896/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/circulating-tumor-dna-in-gastric-adenocarcinoma-future-clinical-applications-and-perspectives/376896.png","ImageObject",300,407,{"name":92,"@type":93},"Mia  ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",15,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is liquid biopsy and ctDNA relevant for gastric adenocarcinoma?","Question",{"text":113,"@type":114},"Liquid biopsy enables identifying and analyzing DNA released by tumor cells into the bloodstream. 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Circulating Tumor DNA in Gastric Adenocarcinoma: Future Clinical Applications and Perspectives. Int. J. Mol. Sci. 2023, 24, 9421. [https://](https://)[ ](https://)[doi.org/10.3390/ijms24119421](doi.org/10.3390/ijms24119421)  \nAcademic Editors: Cristina Peña and Vanesa Garc½a-Barber¡n  \nReceived: 30 April 2023  \nRevised: 25 May 2023  \nAccepted: 27 May 2023  \nPublished: 29 May 2023  \nCopyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Oncology Unit, ASST Cremona, 26100 Cremona, Italy; [giulia.grizzi@asst-cremona.it](giulia.grizzi@asst-cremona.it) (G.G.); [maria.bonomi@asst-cremona.it](maria.bonomi@asst-cremona.it) (M.B.); [mratti.cremona@gmail.com](mratti.cremona@gmail.com) (M.R.); [daniele.spada@asst-cremona.it](daniele.spada@asst-cremona.it) (D.S.)  \n2 Department of Oncology and Hematology, University Hospital of Modena, 41124 Modena, Italy; [maxsalati@live.it](maxsalati@live.it)  \n3 Anne Burnett Marion School of Medicine, Texas Christian University, Fort Worth, TX 76129, USA; [laurenholladaymd@gmail.com](laurenholladaymd@gmail.com)  \n4 Oncology Unit 1, Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; [mariacaterina.degrandis@iov.veneto.it](mariacaterina.degrandis@iov.veneto.it)  \n5 Department of Surgery, ASST Cremona, 26100 Cremona, Italy; [gianluca.baiocchi@unibs.it](gianluca.baiocchi@unibs.it)  \n6 Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy  \n* [Correspondence: michele.ghidini@policlinico.mi.it](Correspondence: michele.ghidini@policlinico.mi.it)  \nAbstract: Gastric cancer (GC) is still one of the most aggressive cancers with a few targetable alterations and a dismal prognosis. A liquid biopsy allows for identifying and analyzing the DNA released from tumor cells into the bloodstream. Compared to tissue-based biopsy, liquid biopsy is less invasive, requires fewer samples, and can be repeated over time in order to longitudinally monitor tumor burden and molecular changes. Circulating tumor DNA (ctDNA) has been recognized to have a prognostic role in all the disease stages of GC. The aim of this article is to review the current and future applications of ctDNA in gastric adenocarcinoma, in particular, with respect to early diagnosis, the detection of minimal residual disease (MRD) following curative surgery, and in the advanced disease setting for treatment decision choice and therapeutic monitoring. Although liquid biopsies have shown potentiality, pre-analytical and analytical steps must be standardized and validated to ensure the reproducibility and standardization of the procedures and data analysis methods. Further research is needed to allow the use of liquid biopsy in everyday clinical practice.  \nKeywords: gastric cancer; liquid biopsy; circulating tumor DNA; minimal residual disease; MRD; ctDNA  \n1. Introduction  \nGastric cancer (GC) is the sixth most common type of cancer and ranks third concerning mortality rate worldwide [1] . In 2020, more than 1 million new cases and 768,793 deaths were estimated globally [2] . In the next years, these burden estimates will increase due to the aging population and the growth of high-risk groups. Surgery and systemic chemotherapy remain the cornerstones of treatment, in addition to target therapy, i","cbCaisRA5z8CSgHo","https://ap.wps.com/l/cbCaisRA5z8CSgHo","pdf",720092,"English","# Abstract\n# Keywords\n# Introduction\n## Epidemiology and current treatment landscape\n## Existing clinical biomarkers and trial evidence\n## Immunotherapy and targeted therapy advances\n## Molecular classifications and clinical applicability","[{\"question\":\"Why is liquid biopsy and ctDNA relevant for gastric adenocarcinoma?\",\"answer\":\"Liquid biopsy enables identifying and analyzing DNA released by tumor cells into the bloodstream. It is less invasive than tissue biopsy and can be repeated over time to monitor tumor burden and molecular changes.\"},{\"question\":\"What clinical uses does ctDNA have in gastric cancer according to the review?\",\"answer\":\"The review focuses on ctDNA for early diagnosis, detecting minimal residual disease (MRD) after curative surgery, and supporting treatment decision-making and therapeutic monitoring in advanced disease.\"},{\"question\":\"What limitations must be addressed before ctDNA can be used routinely?\",\"answer\":\"Pre-analytical and analytical steps need standardization and validation to ensure reproducibility and consistent data analysis. The article also notes that further research is required for everyday clinical practice.\"}]","Circulating Tumor DNA in Gastric Adenocarcinoma - Future Clinical Applications and Perspectives | PDF",1790222038,38]