AccScience Publishing / TD / Online First / DOI: 10.36922/TD025220040
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REVIEW ARTICLE

The evolution of the clinical utility of cell-free DNA in ovarian cancer

Jonathan C. M. Wan1 ,  Michael Flynn1*
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1 Department of Oncology, University College London Hospital, Euston Road, London, United Kingdom
Tumor Discovery, 025220040 https://doi.org/10.36922/TD025220040
Received: 26 May 2025 | Revised: 9 October 2025 | Accepted: 21 October 2025 | Published online: 17 November 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Ovarian cancer remains a leading cause of cancer-related morbidity and mortality. It is one of the few malignancies for which a protein-based biomarker, CA-125, is routinely used for clinical monitoring. However, the limited sensitivity and specificity of CA-125, particularly in early-stage or low-volume disease, restrict its broader clinical utility and highlight the need for more accurate biomarkers. The emergence of circulating tumour DNA (ctDNA) offers potential applications across multiple points in the disease course through its sensitivity, specificity, and ability to genotype tumours non-invasively. ctDNA enables real-time molecular profiling, allowing dynamic assessment of tumour burden, treatment response, and resistance evolution. The critical evaluation of its clinical performance and potential integration with existing protein-based assays is essential to determine its added value. Increasingly, combined protein and ctDNA data highlight a growing trend towards multi-omic analyses, requiring advanced analytical and bioinformatic approaches. This review examines the current landscape, technical challenges, and translational potential of ctDNA and multi-omic assays in ovarian cancer, outlining key steps towards clinical implementation, drawing on lessons from established circulating biomarkers to guide future applications in precision oncology.

Keywords
Ovarian cancer
Liquid biopsy
Circulating tumour DNA
Diagnostics
Funding
None.
Conflict of interest
Jonathan C. M. Wan is an inventor on patents related to methods for circulating tumour DNA detection. He is a co-founder, shareholder, and consultant of Prima Mente, and has served as a consultant for Cleary Gottlieb and Delfi Diagnostics, and Rostrum. Michael Flynn declares no conflicts of interest.
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Tumor Discovery, Electronic ISSN: 2810-9775 Print ISSN: 3060-8597, Published by AccScience Publishing
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