RT Journal Article T1 Emerging noninvasive methylation biomarkers of cancer prognosis and drug response prediction. A1 Oliver, Javier A1 Garcia-Aranda, Marilina A1 Chaves, Patricia A1 Alba, Emilio A1 Cobo-Dols, Manuel A1 Onieva, Juan Luis A1 Barragan, Isabel K1 Biomarkers K1 Cancer treatment K1 Drug response K1 Liquid biopsy K1 Methylation K1 Prognosis AB Cancer is the second leading cause of death worldwide being responsible for 9.6 million deaths in 2018. Epigenetic alterations are key in directing the aberrant expression of tumor-associated genes that drive cellular malignant transformation and cancer progression. Among epigenetic alterations, DNA methylation is the most deeply studied one in relation to environmental exposure. Tissue biopsies have traditionally been the main procedure by which a small sample of body tissue is excised to confirm cancer diagnosis or to indicate the primary site when cancer has spread. In contrast, the analysis of circulating tumor-derived material, or tumor circulome, by means of liquid biopsy of peripheral blood, urine, saliva or sputum is a noninvasive, fast and reproducible alternative to tissue biopsy. Recently, the assessment of epigenetic alterations such as DNA methylation and hydroxymethylation in circulating free DNA has been proved possible. These marks can be associated to prognosis and response to a variety of treatments including chemotherapy, hormonotherapy or immunotherapy. Epigenetic biomarkers may offer some advantages over RNA or genetic biomarkers given their stability in bodily fluids and their high tissue-specificity. While many challenges are still ahead, the unique advantages of these types of biomarkers is urging the scientific community to persevere in their clinical validation and integration into reliable prediction models. This review aims at recapitulating the emerging noninvasive DNA methylated biomarkers of importance for prediction of prognosis and drug response in cancer. PB Elsevier YR 2021 FD 2021-03-16 LK http://hdl.handle.net/10668/22515 UL http://hdl.handle.net/10668/22515 LA en NO Oliver, J., Garcia-Aranda, M., Chaves, P., Alba, E., Cobo-Dols, M., Onieva, J. L., et al. (2022). Emerging noninvasive methylation biomarkers of cancer prognosis and drug response prediction. Seminars in cancer biology, 83, 584–595 NO The work is funded by Instituto de Salud Carlos III through the project “PI18/01592” (to MC) (Co-funded by European Regional Development Fund/European Social Fund “A way to make Europe”/ “Investing in your future”), Sistema Andaluz de Salud, through the projects “SA 0263/2017, Nicol´as Monardes” (to IB) and “PI-0121-2020, RH-0090-2020, Consejería de Salud” (to IB, JO), Spanish Group of Melanoma (Award to Best Research Project 2020) (to IB), Fundaci´ on Bancaria Unicaja through the project “C19048” (to IB, MC), Andalusia- Roche Network Mixed Alliance in Precision Medical Oncology (to IB, EA), and Consejeria de Salud “PI-0121-2020” (to IB). DS RISalud RD Apr 4, 2025