Background: Liquid biopsy, particularly through the analysis of circulating tumor DNA (ctDNA), represents a significant advancement in oncology. Unlike traditional tissue biopsies, ctDNA offers a minimally invasive, real-time approach to cancer management. It has demonstrated considerable potential in early cancer detection, monitoring of therapeutic responses, and assessing minimal residual disease (MRD) to predict recurrence. By enabling comprehensive molecular profiling through a simple blood test, ctDNA supports the core principles of precision oncology, facilitating more personalized and adaptive treatment strategies. Methods: In the following article we describe the recent developments focused on refining ctDNA detection assays to improve sensitivity and specificity. Advanced technologies, including next-generation sequencing (NGS) and digital PCR, are commonly employed. The integration of artificial intelligence (AI) and multi-omics approaches—such as combining genomic, epigenomic, and transcriptomic data—has further enhanced the analytical power of ctDNA assays. Results: Emerging evidence shows that ctDNA-based liquid biopsy enables dynamic, real-time tracking of tumor evolution and therapeutic resistance. Clinical studies have demonstrated its efficacy in detecting early-stage cancers, guiding treatment selection, and predicting relapse with higher accuracy than some conventional methods. Moreover, AI-enhanced algorithms have improved signal detection, allowing for more precise and earlier identification of actionable mutations and MRD. Conclusions: ctDNA analysis via liquid biopsy is poised to revolutionize cancer care by offering a non-invasive, precise, and adaptive tool for tumor characterization and monitoring. Although obstacles remain—particularly regarding assay sensitivity, standardization, and economic feasibility—ongoing technological innovations and multi-omics integration are rapidly advancing its clinical viability. With continued progress, ctDNA-based liquid biopsy is likely to become a cornerstone of routine oncology practice.

TP (tumor protein) 53 mutation status plays a critical role in cancer progression and may influence survival outcomes in non-small cell lung cancer (NSCLC) patients receiving immunotherapy. This study investigates the impact of TP53 mutation status and immunotherapy treatment on survival in NSCLC patients. This retrospective study analyzed NSCLC patients treated with pembrolizumab or ipilimumab plus nivolumab, stratified by TP53 mutation status and PD-L1 (programmed death-ligand 1) expression (50%). Survival outcomes (overall survival (OS) and progression free survival (PFS) were assessed using Kaplan–Meier curves and log-rank tests, with subgroup analysis by histological subtype. In squamous cell cancer (SCC) patients, no significant differences in OS or PFS were found based on TP53 mutation status or treatment type. A trend toward improved survival was observed with pembrolizumab (p = 0.088). In adenocarcinoma patients, significant differences in OS and PFS were observed based on TP53 mutation status. Pembrolizumab showed superior survival outcomes compared to ipilimumab plus nivolumab in TP53 wild-type patients (p < 0.001). PD-L1 ≥ 1% also predicted better outcomes, especially in adenocarcinoma patients. TP53 mutation status and immunotherapy type significantly influence survival outcomes in NSCLC, particularly in adenocarcinoma patients. Pembrolizumab demonstrated superior efficacy in TP53 wild-type patients, with PD-L1 expression further refining survival predictions. These findings underscore the importance of personalized treatment strategies based on TP53 status and PD-L1 expression in NSCLC. Further studies are needed to validate these results and optimize treatment approaches.

Background/Objectives: Oligopolyposis is a rare condition characterized by 10 to 100 adenomas in the colon. We aimed to investigate the clinical and endoscopic features of patients with oligopolyposis by comparing patients who carried pathogenic mutations and those who did not. Methods: This retrospective study included patients with a cumulative count of 10–100 adenomas found in the colon, at a single center. Clinical, endoscopic, and genetic data were analyzed. Results: A total of 155 patients were identified as having oligopolyposis. Genetic testing using a multigene panel was performed among 85 (55%) patients, while founder or family mutation testing was performed among 7 (4.5%) patients. No genetic testing was carried out in 63 (40.5%) patients. Pathogenic polyposis-related mutations were identified in 14 (16%) out of 85 patients who underwent genetic testing. Among these, seven (50%) mutations were found in the APC gene and seven (50%) in the MUTYH gene. A significantly higher proportion of mutation carriers were of Arab ethnicity (35.7% vs. 4.2%, p < 0.001). There was no significant difference between carriers and non-carriers with regard to family history of polyps or cancer. Colorectal cancer was found to be the initial presentation in three (21%) carriers and five (7%) non-carriers. Colonic surgeries were reported among 4 (28.6%) carriers and 13 (18.6%) non-carriers. No significant differences in the rates of colorectal cancer or death were observed between carriers and non-carriers. Conclusions: Only a small proportion of patients with oligopolyposis were found to be mutation carriers, with significant ethnic differences in mutation frequency but no notable differences in clinical features, colorectal cancer rates, or mortality.

Background: Brain metastases (BM) are a common and serious complication in cancer patients, particularly those with lung, breast, or melanoma primaries. As systemic therapies extend survival, the incidence of BM has increased, necessitating improved diagnostic and treatment strategies. Recent advances in neuroimaging and therapy have significantly enhanced the ability to diagnose and manage these lesions with greater precision. Methods: This article summarizes current diagnostic imaging modalities—Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET), Perfusion-Weighted Imaging (PWI), and Magnetic Resonance Spectroscopy (MRS) and their roles in distinguishing tumor progression from treatment effects. It also compares the efficacy of therapeutic options including Whole-Brain Radiation Therapy (WBRT), Stereotactic Radiosurgery (SRS), and systemic therapies such as targeted drugs and immunotherapies. Outcomes were evaluated based on local tumor control and overall survival. Results: Advanced imaging techniques like PWI, MRS, and PET improve diagnostic accuracy by providing functional and metabolic information beyond standard MRI. Therapeutically, SRS offers better local control and fewer cognitive side effects than WBRT for patients with limited metastases. Targeted and immune-based therapies have shown improved survival in patients with specific genetic mutations, supporting a personalized treatment approach. Conclusions: The integration of advanced imaging and individualized therapies has improved diagnosis, treatment decisions, and outcomes in patients with brain metastases. Ongoing research is essential to refine these tools and approaches, further optimizing patient care and quality of life.