Lucia Moretti¹*, Nathaniel Kwan², Sofia Trubetskaya³, Henrik Östlund⁴, Mei Chen
ABSTRACT:
Background: Peritoneal metastases from colorectal cancer (CRC) are associated with limited survival and poor response to systemic therapy. Early detection and accurate monitoring of disease progression remain major challenges due to the limitations of current imaging modalities. Liquid biopsy technologies represent a promising solution by enabling real-time, noninvasive sampling of tumor-derived biomarkers. Methods and Results: This review synthesizes current evidence on the use of circulating tumor DNA (ctDNA), microRNAs, exosomes, and other components as biomarkers for CRC peritoneal carcinomatosis. We discuss their biological relevance, diagnostic sensitivity, and prognostic value. While promising results have been obtained in early studies, clinical translation remains limited due to issues such as low tumor burden, sample degradation, and heterogeneity in biomarker profiles. Conclusion: Liquid biopsy holds significant potential for improving the management of peritoneal metastases in colorectal cancer. Further standardization, large-scale validation, and integration with imaging and clinical parameters are needed to fully realize its role in personalized treatment.