Abstract
BackgroundNon-small cell lung cancer (NSCLC) is one of the most prevalent causes of cancer-related death worldwide. Recently, there are many important medical advancements on NSCLC, such as therapies based on tyrosine kinase inhibitors and immune checkpoint inhibitors. Most of these therapies require tumor molecular testing for selecting patients who would benefit most from them. As invasive biopsy is highly risky, NSCLC molecular testing based on liquid biopsy has received more and more attention recently.ObjectiveWe aimed to introduce liquid biopsy and its potential clinical applications in NSCLC patients, including cancer diagnosis, treatment plan prioritization, minimal residual disease detection, and dynamic monitoring on the response to cancer treatment.MethodWe reviewed recent studies on circulating tumor DNA (ctDNA) testing, which is a minimally invasive approach to identify the presence of tumor-related mutations. In addition, we evaluated potential clinical applications of ctDNA as blood biomarkers for advanced NSCLC patients.ResultsMost studies have indicated that ctDNA testing is critical in diagnosing NSCLC, predicting clinical outcomes, monitoring response to targeted therapies and immunotherapies, and detecting cancer recurrence. Moreover, the changes of ctDNA levels are associated with tumor mutation burden and cancer progression.ConclusionThe ctDNA testing is promising in guiding the therapies on NSCLC patients.
Highlights
Liquid biopsy refers most often to the analysis of tumor-derived materials, including circulating tumor cell (CTC), circulating tumor DNA, circulating tumor RNA, exosome, and tumor-educated platelet (TEP) from blood plasma (Figure 1)
The concentration of circulating tumor DNA (ctDNA) has been suggested to predict the outcomes of patients with nonsmall cell lung cancer (NSCLC), the criterion for appropriate cutoffs is unavailable in clinical utility [7]
We aim to describe the potential clinical application of ctDNA testing, from aiding cancer diagnosis to guiding patients’ treatment and detection of minimal residual disease, and to monitoring the response to cancer treatment in a dynamic way (Figure 2)
Summary
Non-small cell lung cancer (NSCLC) is one of the most prevalent causes of cancer-related death worldwide. There are many important medical advancements on NSCLC, such as therapies based on tyrosine kinase inhibitors and immune checkpoint inhibitors. Most of these therapies require tumor molecular testing for selecting patients who would benefit most from them. As invasive biopsy is highly risky, NSCLC molecular testing based on liquid biopsy has received more and more attention recently
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