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Integrating liquid biopsies in non-small cell lung cancer diagnosis and management: opportunities and challenges

Expert Rev Anticancer Ther. 2026 Feb 15:1-12. doi: 10.1080/14737140.2026.2630026. Online ahead of print.

ABSTRACT

INTRODUCTION: Liquid biopsy has emerged as an important approach to capture tumor-derived material from blood and other body fluids, offering a minimally invasive window into cancer biology. In non - small cell lung cancer (NSCLC), it enables comprehensive molecular profiling that informs patient management, from guiding therapy choices to monitoring disease status and assessing minimal residual disease (MRD).

AREAS COVERED: Its main advantages over tissue biopsy lie in being noninvasive, capable of reflecting tumor heterogeneity and real-time biological changes. These strengths allow liquid biopsy to be applied at different clinical timepoints, including diagnosis, treatment decision-making, evaluation during therapy, detection of resistance, and surveillance for recurrence. Although circulating tumor DNA (ctDNA) remains the most established analyte, the scope is broadening to include circulating RNAs, circulating tumor cells, exosomes, DNA methylation signatures, and tumor-educated platelets, each providing complementary insights. A literature search of PubMed, EMBASE, and Web of Science was conducted without restrictions, supplemented by screening reference lists and major oncology conference abstracts.

EXPERT OPINION: While significant progress has been made integrating liquid biopsies in NSCLC, challenges persist, encompassing issues of standardization, cost, and clinical integration.

PMID:41656166 | DOI:10.1080/14737140.2026.2630026

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Integration of Liquid Biopsy for Optimal Management of NSCLC

Tuberc Respir Dis (Seoul). 2025 Apr 8. doi: 10.4046/trd.2024.0146. Online ahead of print.

ABSTRACT

Molecular profiling of tumours from patients plays a crucial role in precision oncology. While tumour tissue-based genomic testing remains the gold standard in clinical management of patients with non-small cell lung cancer, advances in genomic technologies, the analysis of various bodily fluids, mainly blood but also saliva, pleural/ pericardial effusions, urine, and cerebrospinal fluid is now feasible and readily available. In this review, we will focus on the clinical application of circulating tumour DNA in patients with non-small cell lung cancer in the setting of early-stage disease, locally advanced disease with attention to the potential of ctDNA in prognostication, risk stratification, minimal residual disease, and in advanced disease, its role in the detection of genomic markers and mechanisms of acquired resistance. The role of ctDNA and liquid biopsies in lung cancer screening will also be discussed.

PMID:40195729 | DOI:10.4046/trd.2024.0146

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