{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:29:01Z","timestamp":1785403741309,"version":"3.56.0"},"reference-count":178,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005010","name":"Italian Association for Cancer Research","doi-asserted-by":"publisher","award":["IG-26340"],"award-info":[{"award-number":["IG-26340"]}],"id":[{"id":"10.13039\/501100005010","id-type":"DOI","asserted-by":"publisher"}]},{"award":["IG-26340"],"award-info":[{"award-number":["IG-26340"]}],"id":[{"id":"https:\/\/ror.org\/02g2x7380","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Epithelial ovarian cancers (EOCs) histotypes are characterized by marked molecular heterogeneity and limited effectiveness of current screening and monitoring strategies. Earlier identification of tumor-associated alterations may support timely intervention, especially in genetically predisposed or early-onset patient populations. While liquid biopsy approaches have primarily focused on circulating DNA, RNA, and proteins, increasing evidence indicates that cancer-associated metabolic reprogramming generates measurable informative signals in peripheral biofluids. This review summarizes recent progress in liquid biopsy-derived metabolomics in EOCs, covering analytical platforms applied to serum, plasma, urine, and ascites. Recurrent metabolic signatures linked to tumor burden, disease stage, treatment response, and clinical outcome are described, and their significance in discriminating malignant and non-malignant conditions is critically discussed. Collectively, these findings suggest that metabolomics may provide complementary functional information alongside genomic and histopathological profiling. Although its clinical implementation still requires further validation and methodological standardization, ongoing advances in analytical technologies and the integration of high-dimensional metabolic data into machine learning-based frameworks may progressively support the identification of early tumor-associated alterations and contribute to more accurate disease stratification and biologically informed clinical management.<\/jats:p>","DOI":"10.3390\/diagnostics16131983","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:49:23Z","timestamp":1782434963000},"page":"1983","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Liquid Biopsy-Based Metabolomics in Epithelial Ovarian Cancer: Challenges, Methodological Advances and Translational Considerations"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6127-9656","authenticated-orcid":false,"given":"Mariagrazia","family":"D\u2019Agostino","sequence":"first","affiliation":[{"name":"Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Via Orabona 4, 70125 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5266-1156","authenticated-orcid":false,"given":"Luna","family":"Laera","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Via Orabona 4, 70125 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7608-4026","authenticated-orcid":false,"given":"Martina","family":"Lanza","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, University of Salento, Via per Monteroni, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doron","family":"Tolomeo","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Via Orabona 4, 70125 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6182-4132","authenticated-orcid":false,"given":"Monica","family":"Montopoli","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1696-0028","authenticated-orcid":false,"given":"Clelia Tiziana","family":"Storlazzi","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Via Orabona 4, 70125 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5745-372X","authenticated-orcid":false,"given":"Gennaro","family":"Cormio","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Tumori \u201cGiovanni Paolo II\u201d, Viale Orazio Flacco 65, 70124 Bari, Italy"},{"name":"Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Castegna","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Via Orabona 4, 70125 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7755-2028","authenticated-orcid":false,"given":"Stefano","family":"Miglietta","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Via Orabona 4, 70125 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"ref_1","first-page":"188503","article-title":"Roles of CA125 in diagnosis, prediction, and oncogenesis of ovarian cancer","volume":"1875","author":"Zhang","year":"2021","journal-title":"Biochim. 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