The targeted therapies and immunotherapies in thoracic oncology, particularly for NS-NSCLC, are associated with an increase in the number of predictive biomarkers to be assessed in routine clinical practice. These treatments are administered thanks to marketing authorization for use in daily practice or are evaluated during clinical trials. Since the molecular targets to be identified are more and more complex and numerous, it is now mandatory to use NGS. NGS can be developed from both tissue and fluid (mainly blood). The blood tests in oncology, so-called “liquid biopsies” (LB), are performed with plasmatic circulating free DNA (cf-DNA) and are complementary to the molecular testing performed with a TB. LB use in lung cancer is associated with international guidelines, but additional algorithms could be set up. However, even if useful for better care of patients, notably with advanced and metastatic NS-NSCLC, until now LB are not often integrated into daily practice, at least in Europe and notably in France. The purpose of this review is to describe the different opportunities and algorithms leading to the identification of the molecular signature of NS-NSCLC, using both tissue and liquid biopsies, and to introduce the principle limitations but also some perspectives in this field.
在胸部肿瘤学领域，特别是针对非鳞状非小细胞肺癌（NS-NSCLC）的靶向治疗和免疫治疗，使得临床常规实践中需要评估的预测性生物标志物数量不断增加。这些治疗方案通过获得日常实践使用的上市许可得以应用，或在临床试验中进行评估。由于需要识别的分子靶点日益复杂且数量增多，目前必须采用下一代测序技术（NGS）。NGS既可从组织样本也可从液体样本（主要是血液）中开展。肿瘤学中的血液检测，即所谓的“液体活检”（LB），利用血浆游离DNA（cf-DNA）进行，是对组织活检（TB）分子检测的补充。肺癌中液体活检的应用遵循国际指南，但也可建立额外的检测流程。然而，尽管液体活检有助于改善患者（特别是晚期和转移性NS-NSCLC患者）的诊疗，但迄今为止，至少在欧洲，尤其是法国，液体活检尚未充分融入日常临床实践。本综述旨在阐述通过组织和液体活检识别NS-NSCLC分子特征的不同途径与检测流程，并探讨该领域的主要局限性及未来展望。
Liquid and Tissue Biopsies for Lung Cancer: Algorithms and Perspectives
肿瘤(癌症)患者之家