Elsevier

Journal of Thoracic Oncology

Volume 13, Issue 9, September 2018, Pages 1248-1268
Journal of Thoracic Oncology

Review Article
Liquid Biopsy for Advanced Non-Small Cell Lung Cancer (NSCLC): A Statement Paper from the IASLC

https://doi.org/10.1016/j.jtho.2018.05.030Get rights and content
Under an Elsevier user license
open archive

Abstract

The isolation and analysis of circulating cell-free tumor DNA in plasma is a powerful tool with considerable potential to improve clinical outcomes across multiple cancer types, including NSCLC. Assays of this nature that use blood as opposed to tumor samples are frequently referred to as liquid biopsies. An increasing number of innovative platforms have been recently developed that improve not only the fidelity of the molecular analysis but also the number of tests performed on a single specimen. Circulating tumor DNA assays for detection of both EGFR sensitizing and resistance mutations have already entered clinical practice and many other molecular tests — such as detection of resistance mutations for Anaplastic Lymphoma Kinase (ALK) receptor tyrosine kinase 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 to evaluate current available evidence with the aim of producing a set of recommendations for the use of liquid biopsy for molecular analysis in guiding the clinical management of advanced NSCLC patients as well as identifying unmet needs. In summary, the panel concluded that liquid biopsy approaches have significant potential to improve patient care, and immediate implementation in the clinic is justified in a number of therapeutic settings relevant to NSCLC.

Keywords

Liquid biopsy
NSCLC
cfDNA
ctDNA
Biomarkers
Resistance
Molecular analysis
Targeted therapies

Cited by (0)

Drs. Rolfo and Mack contributed equally to this paper.

Disclosure: Dr. Rolfo has received nonfinancial research support from OncoDNA and other support from Guardant Health. Dr. Mack has received personal fees from Guardant Health and Astra Zeneca. Dr. Scagliotti has received personal fees from Lilly, Roche, Pfizer, Astra Zeneca, Clovis, and Merck Sharp & Dohme. Dr. Barlesi has received personal fees from Astra Zeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Eli Lilly Oncology, F. Hoffmann–La Roche Ltd., Novartis, Merck, Merck Sharp & Dohme, Pierre Fabre, Pfizer, and Takeda. Dr. Mok has received a grant from XCovery; has received grants and personal fees from Astra Zeneca, Roche/Genentech, Bristol-Myers Squibb, Boehringer Ingelheim, Novartis, Merck Sharp & Dohme, Pfizer, Clovis Oncology, SFJ Pharmaceuticals, Taiho, Eisai, and Takeda; personal fees from Eli Lilly, Merck Serono, Vertex, ACEA Biosciences, Oncogenex, Celgene, Ignyta Inc., Fishawack Facilitate Ltd., Janssen, and ChiMed; and has a nonfinancial relationship with geneDecode. Dr. Peled has received grants and personal fees from Astra Zeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Roche, NovellusDx, FMI, and Gaurdant360. Dr. Pirker has received personal fees from Astra Zeneca, Boehringer Ingelheim, Merck Sharp & Dohme, and Genmab Roche. Dr Raez has received grants from NantOmics, Exosomes DX, Liquid Genomics, and Biocept. Dr. Reck has received personal fees from Hoffmann-La Roche, Lilly, Bristol-Myers Squibb, Merck Sharp & Dohme, Merck, Astra Zeneca, Boehringer Ingelheim, Celgene, and Pfizer. Dr. Riess has received personal fees from Takeda, Celgene, Clovis, AbbVie, and Medtronic; and has received grants from Merck, Astra Zeneca, Novartis, and Millenium. Dr. Sequist has received personal fees from Bristol-Myers Squibb, Astra Zeneca, Pfizer, and Genentech; and has been an unpaid consultant for Boehringer Ingelheim, Merrimack, Novartis, and Clovis Oncology. Dr. Sholl has received personal fees from GfK and Genentech. Dr. Tan has received grants from Novartis, Bayer, Astra Zeneca, and GlaxoSmithKline; has received personal fees from Novartis, Boehringer Ingelheim, Merck, Astra Zeneca, Bristol-Myers Squibb, and Roche; and has advisory roles with Novartis, Bayer, and Boehringer Ingelheim. Dr. Wistuba has received grants from Genentech/Roche, Bristol-Myers Squibb, HTG Molecular, Merck, Asuragen, Pfizer, Astra Zeneca/Medimmune, Oncoplex, Amgen, Takeda, EMD Serono, Medimmune, Adaptive, DepArray, and Karus; and has received personal fees from Genentech/Roche, Bristol-Myers Squibb, Boehringer Ingelheim, Medscape, HTG Molecular, Merck, Asuragen, Pfizer, and Astra Zeneca/Medimmune. Dr. Carbone has received personal fees from Abbvie, Adaptimmune, Agenus, Amgen, Ariad, Astra Zeneca, Biocept, Boehringer Ingelheim, Celgene, EMD Serono, Inc., Foundation Medicine, Genentech/Roche, Gritstone, Guardant Health, Inovio, Merck, Merck Sharp & Dohme, Novartis, Palobiofarma, Pfizer, prIME Oncology, Stemcentrx, and Takeda; and has received grants from Bristol-Myers Squibb. Dr. Hirsch is co-inventor of a University of Colorado–owned patent: "EGFR IHC and- FISH as predictive biomarkers for EGFR Therapy"; and is on advisory boards for Abbvie, Astra Zeneca, Biocept, Bristol-Myers Squibb, HTG, Lilly, Merck, Novartis, Pfizer, Roche/Genentech, and Ventana. Dr. Wistuba has received grants and personal fees from Genentech/Roche, Bristol-Myers Squibb, Genentech/Roche, HTG Molecular, Lilly, Merck, Pfizer, and Ventana; and has received laboratory research grants (through the University of Colorado) from Genentech, Bristol-Myers Squibb, Lilly, Bayer, and Clovis Oncology. Dr. Gandara has received personal fees from Foundation Medicine and Guardant Health. The remaining authors declare no conflict of interest.