If a patient’s cancer progresses while undergoing targeted therapy, a re-biopsy is not mandatory. But when evaluating the benefits and risks on a case-by-case basis (transformation to small cell, assessing for a clinical trial), physicians should inform patients about the possible need for a re-biopsy (5). This was a retrospective and multicentre study. A total of 644 patients with lung adenocarcinoma were reviewed, 625 of whom were ruled eligible. From them, 399 were found to show disease progression, and 126 re-biopsies were performed. Progression status, re-biopsy sites, success of obtaining adequate tissue, molecular patterns after re-biopsy and subsequent treatments were analysed. Survival differences among patients with disease progression were then examined according to re-biopsy status. Overall, 625 patients with adenocarcinoma and a median age of 61.4 were evaluated. Initial tyrosine kinase inhibitor (TKI) usage numbered 37 patients (5.9%). Progression was diagnosed in 399 (63.8%) patients, out of which 26 (31.6%) underwent re-biopsies. The successful number of re-biopsies was 103 (81.7%). No complications were observed after any of the biopsy procedures. Subsequent treatments were changed in 15 patients (11.9%), who began new TKI treatments. Poor performance status was the most common reason for not performing a biopsy (n = 65; 23.8%), followed by the physician’s decision (n = 40; 14.6%). Re-biopsies can demonstrate the new characteristics of a tumour and can detect the activation of pre-existing clones, making possible new treatment opportunities for patients. According to the performance status of the patient and the availability of the progressive lesion, we should increase the rate of re-biopsies before the decision to follow up with the best supportive care.

如果患者的癌症在接受靶向治疗期间出现进展，则不必进行重新活检。但是，在根据具体情况评估益处和风险时（转化为小细胞、评估临床试验），医生应告知患者可能需要重新活检 (5)。这是一项回顾性多中心研究。共有 644 名肺腺癌患者接受了审查，其中 625 名患者被判定符合资格。其中 399 例被发现出现疾病进展，并对 126 例进行了重新活检。分析了进展状态、再次活检部位、是否成功获得足够的组织、再次活检后的分子模式以及随后的治疗。然后根据重新活检状态检查疾病进展患者的生存差异。总体而言，对 625 名平均年龄为 61.4 岁的腺癌患者进行了评估。最初使用酪氨酸激酶抑制剂 (TKI) 的患者有 37 名 (5.9%)。 399 名 (63.8%) 患者被诊断出进展，其中 26 名 (31.6%) 接受了再次活检。再次活检的成功次数为 103 例（81.7%）。任何活检程序后均未观察到并发症。 15 名患者 (11.9%) 改变了后续治疗方案，开始新的 TKI 治疗。表现不佳是不进行活检的最常见原因（n = 65；23.8%），其次是医生的决定（n = 40；14.6%）。再次活检可以展示肿瘤的新特征，并可以检测预先存在的克隆的激活，从而为患者提供新的治疗机会。根据患者的体能状态和进展性病变的情况，我们应该增加再次活检的频率，然后再决定采取最佳支持治疗。