Usefulness of Liquid Biopsy for Veteran Patients with Metastatic Lung Cancer

Abstract

Abstract Introduction/Objective The National Comprehensive Cancer Network (NCCN) non-small cell lung cancer (NSCLC) Guidelines Panel strongly advises the use of broad molecular tumor profiling to identify rare driver mutations in patients with advanced or metastatic disease. This testing could either be performed on the tumor sample itself or from liquid biopsy with next generation sequencing. Liquid biopsy presents a minimally invasive opportunity to obtain molecular information from circulating tumor cells (CTC) that may impact treatment. However, the literature of metastatic lung cancers targeted by liquid biopsies and the mutations found is sparse, particularly for the veteran population. Methods/Case Report A retrospective review was performed of all patients with a submitted liquid biopsy specimen at a Veteran Affairs Medical Center (VAMC) from November 26th, 2019, to March 3rd, 2023, to exa mine those patients with metastatic lung cancer. Information on mutations detected was collected. Results (if a Case Study enter NA) There were a total of 35 patient specimens with a history of metastatic lung cancer, from which 34 cases had an available liquid biopsy report. The first liquid biopsy for a patient with metastatic lung cancer was sent on November 26th, 2019. Some of the more common mutations identified through the liquid biopsy included KRAS (7/34), TP53 (15/34), and TERT promoter (3/34). 5 of these 34 cases had no reportable genomic alterations detected. Conclusion Liquid biopsies are a non-invasive, powerful diagnostic tool that is highly useful for broad molecular tumor profiling for precise management and for appropriate counseling of patients on treatment as per the standard of care clinical practice guidelines (such as from the NCCN).