Liquid biopsies for the diagnosis and treatment of lung cancer have developed rapidly, driven primarily by technical advances in sensitivity to detect circulating tumor DNA (ctDNA). Still, technical limitations such as the challenge of detecting low-level ctDNA variants and distinguishing tumor-related variants from clonal hematopoiesis remain. With further technical advancements, new applications for ctDNA analysis are emerging including detection of post-treatment molecular residual disease (MRD), clinical trial selection, and early cancer detection. This chapter reviews the current state of ctDNA testing in NSCLC, the underlying technological advances enabling ctDNA detection, and the potential to expand ctDNA analysis to new applications.

Original languageEnglish
Pages (from-to)165-177
Number of pages13
JournalThoracic surgery clinics
Issue number2
StatePublished - May 1 2020


  • Circulating tumor DNA (ctDNA)
  • Liquid biopsy
  • Non-small cell lung cancer (NSCLC)
  • Plasma genotyping


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