Liquid and Tissue Biopsies for Lung Cancer: Algorithms and Perspectives

Area of Science:

• Oncology
• Molecular Diagnostics
• Thoracic Surgery

Background:

• Targeted therapies and immunotherapies are advancing thoracic oncology, especially for non-small cell lung cancer (NS-NSCLC).
• Increased complexity and number of predictive biomarkers necessitate advanced diagnostic techniques.
• Next-generation sequencing (NGS) is becoming mandatory for identifying these molecular targets.

Purpose of the Study:

• To review opportunities and algorithms for identifying NS-NSCLC molecular signatures.
• To compare tissue biopsies (TB) and liquid biopsies (LB) for molecular profiling.
• To discuss limitations and future perspectives of these diagnostic approaches.

Main Methods:

• Review of current literature on biomarker identification in NS-NSCLC.
• Comparison of NGS applications using tissue and liquid samples (circulating free DNA).
• Analysis of clinical integration of liquid biopsies in routine practice.

Main Results:

• NGS is essential for analyzing complex and numerous biomarkers in NS-NSCLC.
• Liquid biopsies (LB), using circulating free DNA, are a viable complement to tissue biopsies (TB).
• Despite guidelines, LB integration into routine European clinical practice, particularly in France, remains limited.

Conclusions:

• NGS from both tissue and liquid biopsies is key for personalized NS-NSCLC treatment.
• Liquid biopsies show promise for advanced and metastatic NS-NSCLC patient care.
• Further development of algorithms and clinical integration strategies are needed to optimize LB use.