Liquid biopsy in the management of advanced lung cancer: Implementation and practical aspects

Gabriela Fernandes; Ana Rodrigues; Cláudia Matos; Fernando Barata; Luís Cirnes; Lurdes Ferreira; José Albino Lopes; Margarida Felizardo; Paula Fidalgo; Ulisses Brito; Bárbara Parente

doi:10.1016/j.ctarc.2023.100725

Liquid biopsy in the management of advanced lung cancer: Implementation and practical aspects

Cancer Treat Res Commun. 2023:36:100725. doi: 10.1016/j.ctarc.2023.100725. Epub 2023 Jun 7.

Authors

Affiliations

¹ Pulmonology Department, Centro Hospitalar e Universitário de São João, EPE, Porto, Portugal, Faculdade de Medicina da Universidade do Porto, Porto, Portugal, IBMC/i3S - Instituto de Biologia Molecular e Celular/Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. Electronic address: gfernandes@med.up.pt.
² IPO-Porto, Porto, Portugal.
³ Lung Unit, Champalimaud Foundation, Lisboa, Portugal.
⁴ Pulmonology Department, Centro Hospitalar e Universitário de Coimbra, EPE - Hospitais da Universidade de Coimbra, Coimbra, Portugal.
⁵ IPATIMUP/i3s, Porto, Portugal.
⁶ Pulmonology Department, Hospital Braga, Braga, Portugal.
⁷ Pulmonology Department, ULSAM, Viana do Castelo, Portugal; Unidade CUF de Oncologia, Hospital CUF Porto, Porto Portugal.
⁸ Pulmonology Department, Hospital de Loures, Loures, Portugal.
⁹ Medical Oncology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.
¹⁰ Pulmonology Department, Centro Hospitalar e Universitário do Algarve, Faro, Portugal.
¹¹ Pulmonology Department, Hospital CUF Porto, Porto, Portugal.

PMID: 37321073
DOI: 10.1016/j.ctarc.2023.100725

Abstract

Non-small-cell lung cancer (NSCLC) is a major cause of cancer-related death worldwide. In recent years, the discovery of actionable molecular alterations has changed the treatment paradigm of the disease. Tissue biopsies have been the gold standard for the identification of targetable alterations but present several limitations, calling for alternatives to detect driver and acquired resistance alterations. Liquid biopsies reveal great potential in this setting and also in the evaluation and monitoring of treatment response. However, several challenges currently hamper its widespread adoption in clinical practice. This perspective article evaluates the potential and challenges associated with liquid biopsy testing, considering a Portuguese expert panel dedicated to thoracic oncology point of view, and providing practical insights for its implementation based on the experience and applicability in the Portuguese context.

Keywords: Liquid biopsy; Molecular characterization; Next-generation sequencing; Non-small-cell lung cancer; Oncogenic molecular drivers; Therapeutic targets; ctDNA.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Non-Small-Cell Lung* / diagnosis
Carcinoma, Non-Small-Cell Lung* / drug therapy
Carcinoma, Non-Small-Cell Lung* / genetics
Circulating Tumor DNA*
Humans
Liquid Biopsy
Lung Neoplasms* / diagnosis
Lung Neoplasms* / drug therapy
Lung Neoplasms* / genetics
Mutation

Substances

Circulating Tumor DNA