Highly heterogeneous and complex, cancer displays distinct molecular and
cellular characteristics in various tumor types. Despite incredible achievements in
oncology, there is currently no universal diagnostic or therapeutic target. Biomarkers
represent biologically significant molecules that serve as indicators of a disease's
presence, progression, or response to treatment, which are essential for early detection,
prognosis, and precision therapy selection. An ideal biomarker should be adaptable,
allowing its application in different types of cancers while maintaining specificity and
sensitivity at the highest degree. This review will present the state of adaptable
biomarkers and their relevance to unified strategies in diagnostic and treatment settings
among various types of malignancies. Molecular pathways that have a high alteration
frequency in cancer include the TP53, PI3K/AKT/mTOR, and RAS-RAF-MEK
pathways, which offer a basis for adaptable biomarkers and therapeutic targets. These
pathways serve critical roles in cell proliferation, survival, metabolism, and evasion of
the immune response, making them candidates for broad-spectrum cancer therapeutics.
In addition, newly established biomarkers of the TME, such as immune checkpoint
proteins (PD-1, PD-L1, and CTLA-4), metabolic markers (LDH and glutaminase), and
the stromal elements, have been identified as a part of tumour progression and
response. Advances in liquid biopsy technology have further made it possible to detect
circulating tumor DNA (ctDNA), exosomal microRNAs, and tumor-educated platelets,
which enable real-time monitoring of disease dynamics and treatment efficacy. Despite
the promise of adaptable biomarkers, several challenges persist, including tumor
heterogeneity, resistance mechanisms, and economic barriers to widespread
implementation. Addressing these challenges requires a multi-omics approach,
integrating genomics, transcriptomics, proteomics, and metabolomics to refine
biomarker-driven therapeutic strategies. In this review, a comprehensive account is given for the current scenario regarding adaptable biomarkers, therapeutic implications,
and the potential directions ahead in personalized cancer care.
Keywords: Biomarkers, BRAF, Cancer, Circulating tumor DNA, DNA methylation, EGFR, Epigenetic biomarker, Homologous recombination therapy, Immunological biomarker, KRAS.
