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Non-small cell lung cancer: clinical application of liquid biopsy

Liquid biopsy in Germany offers significant advantages in both the diagnosis and treatment of non-small cell lung cancer.

Liquid biopsy approaches involve isolation of circulating tumor cells (CTCs) from a blood sample, DNA or RNA of free cells or exosomes (cell vesicles) from which important and meaningful information about a patient’s cancer status can be obtained.

Compared to obtaining tissue samples for further analysis, liquid biopsy offers significant advantages in both the diagnosis and treatment of non-small cell cancer lung cancer. Blood collection is non-invasive and can be performed at the patient’s treatment site. In addition, it can be repeated several times to monitor disease progression, an approach not possible when obtaining tissue samples.

Despite advances in the treatment of non-small cell lung cancer, patient survival remains low mainly due to late diagnosis. For example, the detection of confirmed biomarkers for CTK1 disease or DNA-free cells could one day be used as a routine screening method for lung cancer in smokers.

Another key advantage of liquid biopsy is the ability to fully characterize the progression and genetic change of the tumor entity during the course of the disease. Intrinsic heterogeneity (difference in features) is a common feature of primary tumors, meaning that the tissue sample is not always representative of the entire tumor entity. Heterogeneity may also exist between tumor and metastasis. Liquid biopsy overcomes these problems by analyzing cells or DNA that may originate from the primary tumor or from metastases.

The main reason for studying heterogeneity is to search for mutations that can be used for targeted therapy. In this context, liquid biopsy is an important step towards personalized medicine. A mutation in exon 20 is important for patients with non-small cell lung cancer gene EGFR which is 50-60% associated with resistance to inhibitors EGFR tyrosine kinase. Other key mutations are rearrangements in the gene ALK , as well as mutations KRAS .

The main trends pursued in recent years are the standardization of analytical methods for liquid biopsy and the development of stable trading platforms for the analysis of biomarkers in body fluids.

«There are biomarkers that could be incorporated into routine clinical practice in the near future, but success depends on validation in sufficiently large, independent, prospectively designed studies,» says Dr. Hoffman, head of the French research team. «The advantage of using liquid biopsy in the diagnosis and treatment of non-small cell lung cancer will be enhanced by the discovery of additional biomarkers to differentiate different forms of the disease in support of the worldwide trend towards personalized medicine.»

The cost of a liquid biopsy in Germany will be 4200 €.

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