Abstract
The field of metabolomics is witnessing a rapid growth in its applications. Applications related to biomarker discovery for the purposes of disease diagnosis constitute a major part of that growth. Of equal interest is the ability to predict and assess treatment responses in various diseases. Obtaining such information before the start of treatment or early on during the treatment, without the need to perform invasive biopsy procedures, would greatly improve patient care and management. This would allow the physician to find alternative treatments and/or modify or stop ongoing treatment when no-response or adverse effects are observed, thereby sparing the patient from continuing with unnecessary and/or toxic treatments. The latter is especially important in the treatment of many cancers. The current literature on the applications of metabolomics to the monitoring of treatment is limited. Here we compile NMR-based metabolomics studies on plasma, serum, and urine geared towards such applications focusing on cancer, hepatotoxicity, neurological disorders, transplants (renal and liver), and sepsis. We discuss the challenges faced in these applications along with approaches to address these difficulties. Finally, insight into the future of this approach and how it can move closer to clinical utility is shared.