Current and future applications of liquid biopsy in nonsmall cell lung cancer from early to advanced stages.

Liquid biopsy refers to the analysis of any tumour-derived material circulating in the blood or any other body fluid. This concept is particularly relevant in lung cancer as the tumour is often difficult to reach and may need an invasive and potentially harmful procedure. Moreover, the multitude of anticancer drugs and their sequential use underline the importance of conducting an iterative assessment of tumour biology. Liquid biopsies can noninvasively detect any targetable genomic alteration and guide corresponding targeted therapy, in addition to monitoring response to treatment and exploring the genetic changes at resistance, overcoming spatial and temporal heterogeneity.In this article, we review the available data in the field, which suggest the potential of liquid biopsy in the area of lung cancer, with a particular focus on cell-free DNA and circulating tumour cells. We discuss their respective applications in patient selection and monitoring through targeted therapy, as well as immune checkpoint inhibitors. The current data and future applications of liquid biopsy in the early stage setting are also investigated.Liquid biopsy has the potential to help manage nonsmall cell lung cancer throughout all stages of lung cancer: screening, minimal residual disease detection to guide adjuvant treatment, early detection of relapse, systemic treatment initiation and monitoring of response (targeted or immune therapy), and resistance genotyping.

Guibert N ，Pradines A ，Favre G ，Mazieres J ... -  《-》

Circulating cell-free nucleic acids and platelets as a liquid biopsy in the provision of personalized therapy for lung cancer patients.

Lung cancer is the predominant cause of cancer-related mortality in the world. The majority of patients present with locally advanced or metastatic non-small-cell lung cancer (NSCLC). Treatment for NSCLC is evolving from the use of cytotoxic chemotherapy to personalized treatment based on molecular alterations. Unfortunately, the quality of the available tumor biopsy and/or cytology material is not always adequate to perform the necessary molecular testing, which has prompted the search for alternatives. This review examines the use of circulating cell-free nucleic acids (cfNA), consisting of both circulating cell-free (tumoral) DNA (cfDNA-ctDNA) and RNA (cfRNA), as a liquid biopsy in lung cancer. The development of sensitive and accurate techniques such as Next-Generation Sequencing (NGS); Beads, Emulsion, Amplification, and Magnetics (BEAMing); and Digital PCR (dPCR), have made it possible to detect the specific genetic alterations (e.g. EGFR mutations, MET amplifications, and ALK and ROS1 translocations) for which targeted therapies are already available. Moreover, the ability to detect and quantify these tumor mutations has enabled the follow-up of tumor dynamics in real time. Liquid biopsy offers opportunities to detect resistance mechanisms, such as the EGFR T790M mutation in the case of EGFR TKI use, at an early stage. Several studies have already established the predictive and prognostic value of measuring ctNA concentration in the blood. To conclude, using ctNA analysis as a liquid biopsy has many advantages and allows for a variety of clinical and investigational applications.

Sorber L ，Zwaenepoel K ，Deschoolmeester V ，Van Schil PE ，Van Meerbeeck J ，Lardon F ，Rolfo C ，Pauwels P ... -  《-》

Tumor-educated platelet as liquid biopsy in lung cancer patients.

Lung cancer is the most frequent cancer for males and third most frequent cancer for females. Targeted therapy drugs based on molecular alterations, such as angiogenesis inhibitors, epidermal growth factor receptor (EGFR) inhibitors, and anaplastic lymphoma kinase (ALK) inhibitors are important part of treatment of NSCLC. However, the quality of the available tumor biopsy and/or cytology material is sometimes not adequate to perform the necessary molecular testing, which has prompted the search for alternatives. This review examines the use of tumor-educated platelet (TEP) as a liquid biopsy in lung cancer patients. The development of sensitive and accurate techniques have made it possible to detect the specific genetic alterations for which targeted therapies are already available. Liquid biopsy offers opportunities to detect resistance mechanisms at an early stage. To conclude, tumor-educated platelet has the potential to be used as liquid biopsy for a variety of clinical and investigational applications.

Liu L ，Lin F ，Ma X ，Chen Z ，Yu J ... -  《-》

Liquid biopsy and its role in an advanced clinical trial for lung cancer.

Johann DJ Jr ，Steliga M ，Shin IJ ，Yoon D ，Arnaoutakis K ，Hutchins L ，Liu M ，Liem J ，Walker K ，Pereira A ，Yang M ，Jeffus SK ，Peterson E ，Xu J ... -  《-》

Liquid Biopsy - Possibilities for Monitoring the Therapeutic Response in Non-Small Cell Lung Cancer.

Lung cancer is the leading cause of death from malignancy worldwide. Its heterogeneity and tumour biology make treatment considerably more difficult. The introduction of target molecules heralded the beginning of the personalized medicine which tailors medical treatments to the molecular and genetic profile of a patient. Liquid biopsy is an innovative, non-invasive method which is used both for diagnostic purposes and for therapeutic monitoring. Liquid biopsy has the potential to help manage non-small cell lung cancer throughout all stages of this cancer: screening, detection of minimal residual disease to guide adjuvant treatment, early detection of relapse, systemic treatment initiation, monitoring of response to targeted or immune therapy, and the emergence of resistance to applied treatment. At present, the study of circulating tumour DNA is used in clinical practice, but circulating tumour cells, miRNAs, exosomes, and platelets formed in the tumour also show promising results.

Raycheva GA ，Ivanov HY ，Grudeva-Popova ZG 《-》