Heidi Pharo, Hege Marie Vedeld, Ingrid Vikan Sjurgard, Rita Pinto, Guro E. Lind
Global cancer incidence continues to rise, emphasizing the urgent need for improved diagnostics and management strategies. DNA methylation biomarkers in liquid biopsies offer a promising, minimally invasive solution. Despite their potential, only a few tests have successfully transitioned from research to clinical practice. This review addresses key aspects influencing successful biomarker development and clinical implementation-including liquid biopsy source selection, biomarker discovery workflow and targeted validation in clinical sample series-and provide strategies to improve accuracy, reproducibility and clinical utility. Altogether, these considerations could aid in bridging the translational gap from research to clinical application, and to increase the number of clinically implemented liquid biopsy tests.