Clinical utility of liquid diagnostic platforms in non-small cell lung cancer

Benjamin Levy, Zishuo I. Hu, Kristen N. Cordova, Sandra Close, Karen Lee, Daniel Becker

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

A firmer understanding of the genomic landscape of lung cancer has recently led to targeted, therapeutic advances in non-small cell lung cancer. Historically, the reference standard for the diagnosis and genetic interrogation for advanced-stage patients has been tissue acquisition via computed tomography-guided core or fine needle aspira- tion biopsy. However, this process can frequently put the patient at risk and remains complicated by sample avail- ability and tumor heterogeneity. In addition, the time required to complete the diagnostic assays can negatively affect clinical care. Technological advances in recent years have led to the development of blood-based diagnostics or “liquid biopsies” with great potential to quickly diagnose and genotype lung cancer using a minimally invasive technique. Recent studies have suggested that molecular alterations identified in cell-free DNA (cfDNA) or circulating tumor DNA can serve as an accurate molecular proxy of tumor biology and reliably predict the response to tyrosine kinasetherapy. Inaddition, several trials have demonstrated the high accuracy of microRNA (miRNA) platforms in discerning cancerous versus benign nodules in high-risk, screened patients. Despite the promise of these platforms, issues remain, including varying sensitivities and specificities between competing platforms and a lack of standardization of techniques and downstream processing. In the present report, the clinical applications of liquid biopsy technologies, including circulating tumor cells, proteomics, miRNA, and cfDNA for NSCLC, are reviewed and insight is provided into the diagnostic and therapeutic implications and challenges of these plat-forms.

Original languageEnglish
Pages (from-to)1121-1130
Number of pages10
JournalOncologist
Volume21
Issue number9
DOIs
StatePublished - Sep 2016

Keywords

  • Cell-free DNA
  • Circulating tumor cells
  • Liquid diagnostics
  • MicroRNA
  • Non-small cell lung cancer

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