Circulating free tumor DNA in non-small cell lung cancer (NSCLC): clinical application and future perspectives

J Thorac Dis. 2019 Jan;11(Suppl 1):S113-S126. doi: 10.21037/jtd.2018.12.18.

Abstract

Major advances in the treatment of non-small cell lung cancer (NSCLC) patients have been obtained during the last decade. Molecular testing of tumor samples is therefore mandatory in routine clinical practice. Tumor DNA is also present as cell-free molecules in blood, which is therefore a very useful and convenient source of tumor DNA. In this review, we discuss pre-analytical and analytical aspects of circulating tumor DNA (ctDNA) analysis. We also describe the use of ctDNA analysis in routine clinical practice, and discuss the potential use of ctDNA monitoring both to identify minimal residual disease and as a potential tool to early identify patients' response to treatment.

Keywords: ALK translocation; Circulating tumor DNA (ctDNA); EGFR mutation; minimal residual disease (MRD); non-small cell lung cancer (NSCLC); tumor mutation burden (TMB).

Publication types

  • Review