Clinical Utility and Application of Liquid Biopsy Genotyping in Lung Cancer: A Comprehensive Review

Abstract

Precision medicine has revolutionized the therapeutic management of cancer patients with a major impact on non-small cell lung cancer (NSCLC), particularly lung adenocarcinoma, where advances have been remarkable. Tissue biopsy, required for tumor molecular testing, has significant limitations due to the difficulty of the biopsy site or the inadequacy of the histological specimen. In this context, liquid biopsy, consisting of the analysis of tumor-released materials circulating in body fluids, such as blood, is increasingly emerging as a valuable and non-invasive biomarker for detecting circulating tumor DNA (ctDNA) carrying molecular tumor signatures. In advanced/metastatic NSCLC, liquid biopsy drives target therapy by monitoring response to treatment and identifying eventual genomic mechanisms of resistance. In addition, recent data have shown a significant ability to detect minimal residual disease in early-stage lung cancer, underlying the potential application of liquid biopsy in the adjuvant setting, in early detection of recurrence, and also in the screening field. In this article, we present a review of the currently available data about the utility and application of liquid biopsy in lung cancer, with a particular focus on the approach to different techniques of analysis for liquid biopsy and a comparison with tissue samples as well as the potential practical uses in early and advanced/metastatic NSCLC.

Keywords:

• circulating tumor DNA
• liquid biopsy
• EGFR
• minimal residual disease
• sequencing technologies
• lung cancer
• early-stage
• non-small cell lung cancer

Author Contributions

All authors made significant contributions to the reported work, whether in conception, study design, execution, data acquisition, analysis and interpretation, or all of these areas; participated in the drafting, review or critical review of the article; gave final approval of the version to be published; agreed on which journal the article was submitted to; and agrees to be responsible for all aspects of the job.

Disclosure

The authors declare that they have no conflicts of interest in this work.

Additional information

Funding

There is no funding to report.