{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T20:23:04Z","timestamp":1788812584677,"version":"build-2803163510"},"reference-count":73,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Colorectal cancer (CRC) remains one of the leading causes of cancer\u2010related mortality worldwide, with outcomes critically dependent on timely diagnosis, accurate risk stratification, and individualized treatment. Traditional markers such as CEA, KRAS\/NRAS, BRAF, and MSI status, while foundational, are insufficient to address the full complexity of CRC biology. Over the past decade, a new generation of biomarkers has emerged spanning liquid biopsy, stool\u2010based methylation, genomics, epigenomics, immune profiling, microbiome analysis, radiomics, patient\u2010derived organoids, and multiomics integration\u2014collectively redefining how CRC is detected, classified, and treated. This narrative review synthesizes evidence from 73 human studies published between 2010 and 2024, identified through structured searches of PubMed, Embase, Web of Science, and the Cochrane Library, and quality\u2010assessed using QUADAS\u20102 and Newcastle\u2010Ottawa tools. Circulating tumor DNA (ctDNA) emerged as the most clinically validated biomarker, demonstrating superior performance in minimal residual disease (MRD) detection, recurrence prediction, and real\u2010time therapy monitoring. Stool DNA methylation assays showed strong sensitivity for early CRC and advanced adenoma detection. Genomic markers including BRAF V600E, POLE\/POLD1, HER2, and KRAS G12C now directly inform targeted therapy selection, while immune biomarkers\u2014MSI\u2010H, TMB, and Immunoscore\u2014guide immunotherapy decisions and stratify prognosis beyond TNM staging. Microbiome signatures, particularly\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Fusobacterium nucleatum<\/jats:italic>\n                    <\/jats:styled-content>\n                    and colibactin\u2010producing\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                    <\/jats:styled-content>\n                    , were associated with chemo resistance and tumor progression. Radiomics and AI\u2010driven imaging models provided noninvasive assessment of nodal involvement and neo\u2010adjuvant therapy response. Patient\u2010derived organoids demonstrated capacity to predict individual drug sensitivity, and multiomic integration enabled refined molecular subtyping. Despite this progress, widespread clinical adoption remains limited by assay variability, lack of prospective multicenter validation, and implementation barriers including cost and infrastructure. As these technologies mature, their integration into standardized, multidisciplinary workflows will be essential to translating biomarker innovation into improved patient outcomes across all stages of CRC care.\n                  <\/jats:p>","DOI":"10.1111\/jgh.70420","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T23:39:27Z","timestamp":1779147567000},"page":"2030-2042","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Circulating Tumor DNA and Precision Biomarkers in Colorectal Cancer: Implications for Diagnosis, Monitoring, and Management of Advanced Disease"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8680-4170","authenticated-orcid":false,"given":"Vijay\u00a0Kumar","family":"Srinivasalu","sequence":"first","affiliation":[{"name":"Molecular Immunology Mazumdar Shaw Medical Foundation  Bangalore India"},{"name":"MAHE  Manipal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narayana","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Molecular Immunology Mazumdar Shaw Medical Foundation  Bangalore India"},{"name":"MAHE  Manipal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Sakra World Hospital  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjula","family":"Das","sequence":"additional","affiliation":[{"name":"Molecular Immunology Mazumdar Shaw Medical Foundation  Bangalore India"},{"name":"CPDTRI  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aaf6219"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2019.0528"},{"issue":"21","key":"e_1_2_5_4_1","first-page":"5447","article-title":"Circulating Tumor DNA to Monitor Therapy and Resistance in Metastatic CRC","volume":"26","author":"Morris V. 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