Single circulating tumor cell omics: Technologies and clinical applications

Wenyi Zhang; Liyong He; Chaima Merzougui; Wenjia Wang; Kaiqiang Ye; Handong Wang; Jiahao Shen; Peidong Qi; Yan Huang; Bangshun He; Xiangwei Zhao

doi:10.59717/j.xinn-med.2026.100227

The Innovation Medicine > 2026 Vol. 4 > No. 3 > 100227

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Single circulating tumor cell omics: Technologies and clinical applications

1.
State Key Laboratory of Digital Medical Engineering, School of Biological Science & Medical Engineering, Southeast University, Nanjing 210096, China
2.
Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

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Corresponding authors: bhe@njmu.edu.cn (B.H.); xwzhao@seu.edu.cn (X.Z.)
Received Date: January 26, 2026

Accepted Date: July 09, 2026

Published Online: July 10, 2026

The Innovation Medicine 4(3), https://doi.org/10.59717/j.xinn-med.2026.100227 | Cite this article

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PUBLIC SUMMARY

PUBLIC SUMMARY
1. Circulating tumor cells (CTCs) carry tumor DNA, RNA, and proteins in blood for non-invasive diagnosis.
  
  Single-cell omics technologies reveal CTC genomes, transcriptomes, proteomes, and metabolomes.
  
  CTC single-cell omics aids early detection, guides therapy, tracks drug resistance, and predicts prognosis.
  
  This review covers CTC enrichment, single-cell omics, and their clinical application in oncology.
  
  Integrating multi-omics with artificial intelligence and CTC models will advance precision cancer medicine.

ABSTRACT

ABSTRACT

Disseminating from primary or metastatic lesions, circulating tumor cells (CTCs) enter various body fluids—including blood, cerebrospinal fluid, and pleural effusions—acting as a liquid biopsy that provides a comprehensive molecular repository. The rapid maturation of single-cell omics has redefined CTC analysis, shifting the focus from simple enumeration to high-resolution molecular characterization. The application of these single-cell technologies has become pivotal for the next generation of precision oncology. This review first delineates the landscape of CTC enrichment, critically evaluating mainstream strategies based on biophysical and biochemical properties alongside emerging innovations. We then analyze the workflow of CTC single-cell omics analysis across five core dimensions: isolation techniques, genomics, transcriptomics, proteomics, and metabolomics. Furthermore, we highlight the clinical translational value of these approaches across four critical axes: early cancer detection, molecular subtyping for companion diagnostics, dynamic monitoring of therapeutic resistance, and prognostic risk stratification. The analysis concludes by addressing current technical bottlenecks and outlining a roadmap for integrating CTC profiling into routine clinical practice.

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Zhang W., He L., Merzougui C., et al. (2026). Single circulating tumor cell omics: Technologies and clinical applications. The Innovation Medicine 4:100227. https://doi.org/10.59717/j.xinn-med.2026.100227

Zhang W., He L., Merzougui C., et al. (2026). Single circulating tumor cell omics: Technologies and clinical applications. The Innovation Medicine 4:100227. https://doi.org/10.59717/j.xinn-med.2026.100227

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