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.

中文翻译：

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IASLC 声明文件：晚期非小细胞肺癌 (NSCLC) 的液体活检

摘要 血浆中循环无细胞肿瘤 DNA 的分离和分析是一种强大的工具，在改善包括 NSCLC 在内的多种癌症类型的临床结果方面具有相当大的潜力。使用血液而不是肿瘤样本的这种性质的分析通常被称为液体活检。最近开发了越来越多的创新平台，不仅提高了分子分析的保真度，而且还提高了对单个样本进行的测试数量。用于检测 EGFR 致敏突变和耐药突变的循环肿瘤 DNA 检测已经进入临床实践，许多其他分子测试——例如间变性淋巴瘤激酶 (ALK) 受体酪氨酸激酶重排的耐药突变检测——可能会在近期内实现未来。由于有大量新证据，因此需要进行评估以审查优势和劣势，描述临床实践中已经实施的内容和尚未实施的内容，并突出需要进一步调查的领域。国际肺癌研究协会召集了一个胸部肿瘤学领域的多学科专家小组，他们对液体活检和分子病理学感兴趣并具有专业知识，以评估当前可用的证据，目的是提出一套使用建议用于分子分析的液体活检在指导晚期 NSCLC 患者的临床管理以及确定未满足的需求方面的应用。总之，专家组得出结论，液体活检方法具有改善患者护理的巨大潜力，