IASLC Consensus Statement on Liquid Biopsy for Patients With Advanced NSCLC
Posted: Wednesday, August 18, 2021
Advances in liquid biopsy techniques have spurred the International Association for the Study of Lung Cancer (IASLC) to release a consensus statement confirming new recommendations for using broad-based plasma circulating tumor DNA (ctDNA) analysis to treat patients with advanced non–small cell lung cancer (NSCLC). In the Journal of Thoracic Oncology, According to David Gandara, MD, of the UC Davis Comprehensive Cancer Center, and colleagues: “[The] key to personalized therapeutic decision-making in advanced NSCLC is broad-based genomic testing, now commonly performed by next-generation sequencing in order to simultaneously assess all treatable oncogene targets.”
Since IASLC guidelines for liquid biopsy were published last (2018), strides in deep-sequencing coverage, molecular barcoding, and error correction of algorithms have led to sufficient improvements in next-generation sequencing ctDNA analysis that it is now appears to be more accurate than non–next-generation sequencing polymerase chain reaction (PCR)-based assays. For this reason, when assessing guideline-recommended oncogene targets in patients with advanced NSCLC, testing of plasma should be performed by a clinically validated next-generation sequencing platform rather than single-gene PCR-based testing. In patients with oncogene-driven cancers, liquid biopsy is not just complementary to tissue-based biopsy, but can be used as an initial approach for testing biomarker evaluation (at the time of diagnosis) and for monitoring the efficacy of targeted therapies.
Despite concerns about availability and reimbursement, data suggest that next-generation sequencing appears to be more cost-effective than sequential or hot-spot platforms. In addition, the technology is expected to have a growing role in treating lung cancer in the future. “We fully anticipate that the role of liquid biopsy will continue to increase in the near and long-term future, to the betterment of practicing oncologists and the patients [with lung cancer] we treat,” the authors stated.
Disclosure: For full disclosures of the study authors, visit jto.org.