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Updated: Oct 27, 2025
Detection of Cell-Free DNA in Blood Plasma Samples of Cancer Patients
Published on: September 9, 2020
Update on molecular pathology and role of liquid biopsy in nonsmall cell lung cancer
Pamela Abdayem1, David Planchard2
1Dept of Cancer Medicine, Thoracic Group, Gustave Roussy Cancer Campus, Villejuif, France.
Abstract:
Personalised medicine, an essential component of modern thoracic oncology, has been evolving continuously ever since the discovery of the epidermal growth factor receptor and its tyrosine kinase inhibitors. Today, screening for driver alterations in patients with advanced lung adenocarcinoma as well as those with squamous cell carcinoma and no/little history of smoking is mandatory. Multiplex molecular platforms are preferred to sequential molecular testing since they are less time- and tissue-consuming. In this review, we present the latest updates on the nine most common actionable driver alterations in nonsmall cell lung cancer. Liquid biopsy, a simple noninvasive technique that uses different analytes, mostly circulating tumour DNA, is an appealing tool that is used in thoracic oncology to identify driver alterations including resistance mutations. Additional roles are being evaluated in clinical trials and include monitoring the response to treatment, screening for lung cancer in high-risk patients and early detection of relapse in the adjuvant setting. In addition, liquid biopsy is being tested in immune-oncology as a prognostic, predictive and pharmacodynamic tool. The major limitation of plasma-based assays remains their low sensitivity when compared to tissue-based assays. Ensuring the clinical validity and utility of liquid biopsy will definitely optimise cancer care.
Insights
Personalized medicine in thoracic oncology is advancing with mandatory screening for driver alterations in lung cancer. Multiplex testing and liquid biopsy are key tools for identifying these alterations and improving patient care.
Area of Science:
- Oncology
- Molecular Diagnostics
- Thoracic Surgery
Background:
- Personalized medicine is crucial in modern thoracic oncology.
- Screening for driver alterations is now mandatory for advanced lung cancer patients.
Purpose of the Study:
- To review the latest updates on common actionable driver alterations in non-small cell lung cancer.
- To highlight the role of multiplex molecular platforms and liquid biopsy.
Main Methods:
- Review of current literature on driver alterations in non-small cell lung cancer.
- Discussion of multiplex molecular platforms versus sequential testing.
- Evaluation of liquid biopsy applications and limitations.
Main Results:
- Nine common actionable driver alterations in non-small cell lung cancer are presented.
- Multiplex platforms are more efficient than sequential testing.
- Liquid biopsy shows promise for identifying alterations, monitoring treatment, and early detection, despite lower sensitivity than tissue assays.
Conclusions:
- Multiplex testing and liquid biopsy are essential tools in thoracic oncology.
- Further validation of liquid biopsy is needed to optimize cancer care.
- Personalized medicine approaches are continuously evolving for better lung cancer treatment.
