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Complementary roles for tissue and blood based comprehensive genomic profiling for detection of actionable driver alterations in advanced NSCLC

Published

August 2022

Citation

Schwartzberg LS, Li G, Tolba K, Bourla AB, Schulze K, Gadgil R, FineA, Lofgren KT, Graf RP, Oxnard GR, Daniel D. Complementary roles for tissue and blood based comprehensive genomic profiling for detection of actionable driver alterations in advanced NSCLC. JTO Clinical and Research Reports. 2022. https://doi.org/10.1016/j.jtocrr.2022.100386

Our summary

Precision oncology has changed the way cancer patients are cared for, and nowhere is this more true than in the care of advanced non-small cell lung cancer (aNSCLC). Wide adoption of molecular profiling paved the way for the rapid development of targeted therapies for patients with aNSCLC. Advances in precision oncology are premised on availability of tumor-derived genomic material suitable for molecular profiling. Traditionally tumor biopsy has been considered the gold standard for genomic profiling; however, recent advances in liquid biopsy have created an additional diagnostic approach to increase access to personalized cancer therapy. 

This study looked at a prospective cohort of patients with advanced NSCLC where patients received liquid biopsy CGP and also were offered tissue CGP as a complement to their standard of care testing.

Why this matters

With such a diversity of diagnostic tools, a key clinical question is how to piece these diagnostics together to optimally identify precision treatment options for patients with aNSCLC. Liquid biopsy has the potential to eliminate the need for a confirmatory tissue test, reserving it for those who truly need it – and if a liquid biopsy is ordered first when availability of tissue is in question, it can enable earlier treatment decision making. Although liquid biopsy is a compelling pragmatic alternative when tissue is not available, more studies are needed to understand how liquid biopsy adds value when comprehensive genomic profiling (CGP) of tumor tissue is available.

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