bims-ovdlit Biomed News
on Ovarian cancer: early diagnosis, liquid biopsy and therapy
Issue of 2026–02–22
seven papers selected by
Lara Paracchini, Humanitas Research



  1. Nat Cancer. 2026 Feb 19.
      Cell-free DNA analysis via methylation and fragmentation profiling has advanced minimally invasive cancer detection; however, broader application has been limited by small cohorts and inconsistent data processing. Here we collated 1,074 cfMeDIP-seq profiles across 9 studies, comprising cancer samples from 11 cancer types, carriers of Li-Fraumeni syndrome and healthy controls. We developed a uniform computational workflow to mitigate technical and biological confounders across cohorts. This analysis identified 14,202 pancancer differentially methylated regions for cancer detection, along with cancer-specific markers for subtype monitoring. Fragmentomic profiling revealed distinguishing differences in 5' end motifs, fragment lengths and nucleosome footprints across cancers. Integrating methylome and fragmentome features enhanced cancer detection and classification. Validation in 220 independent samples, including 3 cancer types absent from the primary dataset, confirmed the robustness of our findings. Altogether, this work provides a pancancer cell-free DNA resource of 1,294 samples to support future methylome and fragmentome studies.
    DOI:  https://doi.org/10.1038/s43018-026-01116-3
  2. Int Rev Cell Mol Biol. 2026 ;pii: S1937-6448(24)00161-8. [Epub ahead of print]399 113-143
      Liquid biopsies are emerging as promising approaches to capture minimal residual disease (MRD) and interpret the heterogeneity of pathological responses after neoadjuvant therapy for patients with early stage cancers. Minimally invasive analyses of circulating cell-free tumor DNA (ctDNA) are enabled by advances in next generation sequencing and bioinformatic methodologies, resulting in sensitive and specific ctDNA detection. Emerging data supports the clinical utility of ctDNA status at different timepoints during the treatment trajectory and ctDNA MRD has been shown to predict clinical outcomes. Herein, we critically review ctDNA technologies and their analytical performance together with an assessment of the clinical sensitivity of these approaches to predict disease recurrence.
    Keywords:  Circulating tumor DNA; Early stage cancer; Liquid biopsies; Minimal residual disease
    DOI:  https://doi.org/10.1016/bs.ircmb.2024.12.002
  3. Nat Commun. 2026 Feb 14.
      The abundance, dynamics, and context-dependent heterogeneity of DNA methylation, where a pattern considered abnormal in one cell type may be normal in another, complicate the identification of early methylation changes that drive or signal disease development. This complexity can obscure early markers of increased disease risk, making it challenging to detect and intervene in disease processes at their inception. Here, we report 31,744 CpG loci exhibiting highly consistent methylation profiles in the blood of young, healthy individuals. We assess alterations at these epigenetically stable loci in 8,886 individuals across 29 diverse cohorts, including those with hematological cancers (n = 3159), cardiovascular complications (n = 2788), and healthy controls (n = 2939). Our findings reveal methylation pattern disruption in myeloid and lymphoid malignancies, correlating with clonal burden dynamics and mutation frequency throughout leukemia treatment. In non-cancer cohorts, we observe that methylation levels at epigenetically stable loci become increasingly variable with age, a shift linked to higher cardiovascular disease risk and lower survival rates. This study highlights DNA methylation instability as a blood-based biomarker for both hematological cancer and cardiovascular disease and uncovers a mechanistic link between methylation dynamics and the expansion of maladaptive hematopoietic clones.
    DOI:  https://doi.org/10.1038/s41467-026-69430-z
  4. Nat Rev Genet. 2026 Feb 17.
      Genome annotation captures the essence of a genome by cataloguing its genes, transcripts, proteins and other functional elements of the DNA sequence. Accurate annotation serves as the foundation for a wide range of downstream analyses and discoveries, ranging from basic biology to an understanding of the linkage between genes and disease. Over the past two decades, advances in high-throughput sequencing techniques have enabled faster and more accurate capture of diverse genomic features, generating data at an unprecedented scale. Concurrently, computational methods for translating these data into evidence for genome annotation have steadily improved, leading to better automated genome annotation systems. As such, the growing number of sequenced genomes provides a positive feedback loop, in which database searches become more effective and shared sequence patterns emerge more clearly. These advances are promising steps towards annotating the functions of many poorly understood genes, particularly non-coding RNA genes, for which more research is needed.
    DOI:  https://doi.org/10.1038/s41576-026-00937-3
  5. Nat Rev Clin Oncol. 2026 Feb 20.
      Colorectal cancer (CRC) is a heterogeneous malignancy, with various alterations in molecular signalling pathways driving disease progression and resistance to therapy. Liquid biopsy, as a source of circulating tumour DNA (ctDNA), has been utilized to characterize tumour molecular heterogeneity, facilitating the identification of actionable targets for precision medicine-guided therapies and the detection of emerging genomic drivers of drug resistance in patients with metastatic CRC. In addition, liquid biopsy-based analysis of ctDNA has been validated as a tool for detecting minimal residual disease (MRD) following locoregional treatment in patients with localized colon or rectal cancer, offering improved prognostic stratification and supporting the tailoring of adjuvant systemic therapy. Methodological evolution from PCR analysis of a few known mutations in one gene or a small panel of genes to the assessment of hundreds of genes and pathogenic variants by next-generation sequencing has enabled comprehensive genomic profiling (CGP), thereby improving knowledge of cancer molecular complexity at the individual patient level. In this respect, liquid biopsy-based CGP is an easily repeatable and minimally invasive approach that can provide a dynamic portrait of CRC molecular heterogeneity to guide personalized and adaptive treatment based on biomarkers of response and resistance. In this Review, we discuss current and potential roles of liquid biopsy-based ctDNA analysis in the clinical management of metastatic CRC. We also discuss the evidence supporting implementation of liquid biopsy-based assessment of MRD to refine the management of locoregional CRC and potentially improve cure rates while reducing overtreatment of many patients.
    DOI:  https://doi.org/10.1038/s41571-026-01126-1
  6. Nat Genet. 2026 Feb 16.
      Clonal hematopoiesis (CH) results from the acquisition and expansion of somatic mutations in hematopoietic stem and progenitor cells and is associated with age-related clinical sequelae, including an increased risk for cardiovascular disease, myeloid neoplasms and complications related to cancer therapy. Chemotherapy and radiation can accelerate CH expansion and further elevate the risk of adverse events, including cardiotoxicity and therapy-related myeloid neoplasms. Although CH is increasingly recognized as a clinically relevant precursor state and predictive biomarker, the long-term dynamics of CH expansion in humans remain poorly understood. Longitudinal data are often collected but not integrated with mathematical prediction. Mathematical modeling is essential for characterizing CH evolution, estimating clone fitness, inferring stem cell pool dynamics and enabling patient-level predictions. This study summarizes the current evidence on CH dynamics in humans, compares mathematical models used to predict CH progression, assesses the validity of model assumptions and discusses the implications for clinical management of individuals with these precursor conditions.
    DOI:  https://doi.org/10.1038/s41588-026-02504-2