Advances in plasma metabolomics detection technology and its clinical applications in lung cancer and other malignancies.

Metabolic reprogramming is a fundamental hallmark distinguishing tumor cells from their normal counterparts. This process leads to pronounced alterations in the types and concentrations of metabolites present in the bodily fluids of cancer patients via liquid biopsy approaches. Plasma and serum, owing to their minimally invasive collection, repeatability, and ability to reflect systemic metabolic status, have emerged as optimal sample types for clinical metabolomics. These metabolic changes serve as valuable indicators for inferring disease progression and predicting patient prognosis. Lung cancer, particularly non-small cell lung cancer (NSCLC), with its high global incidence and mortality, represents a critical area where plasma metabolomics can address unmet clinical needs in prognostic prediction and therapeutic stratification. This review focuses primarily on lung cancer. However, the scarcity of studies investigating the prognostic value of metabolite alterations in lung cancer promoted the inclusion of research from other malignancies as well. This review first summarizes the current liquid biopsy metabolomics detection technologies and associated biological materials, followed by an overview of tumor-related metabolic pathway alterations. It then discusses the clinical applications of these principles in prognostic prediction and therapeutic evaluation. The aim is to provide a comprehensive overview and inspire future research directions in this field.