J Thorac Oncol. 2018 Jun 6. pii: S1556-0864(18)30680-4. doi: 10.1016/j.jtho.2018.05.030. [Epub ahead of print]
IASLC Statement Paper: Liquid Biopsy for Advanced Non-Small Cell Lung Cancer (NSCLC).
Rolfo C1, Mack PC2, Scagliotti GV3, Baas P4, Barlesi F5, Bivona TG6, Herbst RS7, Mok TS8, Peled N9, Pirker R10, Raez LE11, Reck M12, Riess JW13, Sequist LV14, Shepherd FA15, Sholl LM16, Tan DS17, Wakelee HA18, Wistuba II19, Wynes MW20, Carbone DP21, Hirsch FR22, Gandara DR23.
The isolation of circulating cell-free tumoral DNA (ctDNA) in plasma and its subsequent molecular analysis is a powerful tool that can help improve clinical outcomes across multiple cancer types, including non-small cell lung cancer (NSCLC). Assays of this nature that utilize blood as opposed to tumor samples are frequently referred to as liquid biopsies. An increasing number of new platforms have been recently developed that improve not only the fidelity of the molecular analysis of the liquid biopsy but also the number of tests performed on a single specimen. ctDNA assays for detection of both epidermal growth factor receptor (EGFR) sensitizing and resistance mutations have already entered clinical practice and many other molecular tests - such as resistance mutations for ALK rearrangements - are likely to do so in the near future. Due to an abundance of new evidence, an appraisal was warranted to review strengths and weaknesses, to describe what is already in clinical practice and what has yet to be implemented, and to highlight areas in need of further investigation. A multidisciplinary panel of experts in the field of thoracic oncology with interest and expertise in liquid biopsy and molecular pathology, was convened by the International Association for the Study of Lung Cancer (IASLC) to evaluate current available evidence with the aim of producing a set of recommendations for the use of liquid biopsy for molecular analysis in in guiding the clinical management of advanced NSCLC patients as well as identifying unmet needs.
Biomarkers; Liquid biopsy; NSCLC; Resistance; cfDNA; ctDNA; molecular analysis; targeted therapies