Abstract
The nature of « targetable oncogenic drivers » makes their identification essential for optimal management of patients with non-small cell lung cancer (NSCLC). The different tissue samples - biopsie, cytology - are all usefull for this diagnosis. The molecular characterization of circulating tumor DNA has become a valuable tool for the identification of these drivers, more in the follow-up of NSCLC patients under targeted therapeutics. The techniques have evolved with the development of next generation sequencing (NGS) allowing analysis of dozens of genes simultaneously and very sensitive techniques such as digital PCR. Recurrent mutations (EGFR mutation, T790M) can be found by a targeted technique or digital PCR. Non-recurrent mutations (ALK resistance mutations) must be detected by a technique without a priori, such as NGS. The development of such new techniques must be compatible with optimal patient management in terms of cost and time.
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