Moving liquid biopsies to the Front-line of lung cancer treatment decisions

Abstract

Liquid biopsies have evolved as a promising non-invasive technology for cancer diagnosis and treatment, as they provide a comprehensive analysis of tumor-derived biomarkers. Prospective multicenter studies have shown the efficacy of liquid biopsies, including circulating tumoral DNA (ctDNA) and more recently cfRNA analysis, in identifying biomarkers for targeted therapies in patients with non-small cell lung cancer (NSCLC). In addition, studies have demonstrated a reduced time to treatment initiation when liquid biopsies are used in conjunction with or in lieu of tissue genotyping. Although liquid biopsies hold excellent potential, there are several obstacles to overcome, including technical limitations, standardization of methodologies, and cost-effectiveness. However, ongoing research and technological advances are conquering these obstacles, resulting in enhanced performance and dependability of liquid biopsy assays. To maximize the clinical utility of liquid biopsies, it is necessary to continue research, validation studies, and standardization initiatives. The incorporation of liquid biopsies into standard clinical practice has the potential to revolutionize the diagnosis and treatment of cancer. These noninvasive tests not only are a great tool for diagnosis but also allow real-time monitoring, guide treatment decisions, and enhance patient outcomes. As the costs of next-generation sequencing (NGS) declines, global access to liquid biopsies is anticipated to increase. Liquid biopsies arrived in the clinical practice after we were familiar with the analysis of genetic aberrations in tissue by next generation sequencing (NGS) that is considered the standard of care in new patients with the diagnosis of metastatic non-small cell lung cancer (NSCLC) and sometimes are used now as complement of tissue analysis or only when there is not enough tissue available. We already have done enough studies that show the non-inferiority and equivalence of liquid biopsies with molecular tissue testing. This article explores recent studies that demonstrate the clinical utility and potential of liquid biopsies in oncology including the possibility to use them at the same time of tissue analysis and the comparison of both with the advantage for the patient to get an earlier result due to the shorter turnaround time of liquid biopsies.

Keywords

• Liquid biopsies
• Next generation sequencing (NGS)
• Precision medicine