The following is a summary of the “Liquid Biopsy Versus Tissue Biopsy to Determine Front Line Therapy in Metastatic Non-Small Cell Lung Cancer (NSCLC),” published in the March 2023 issue of Lung Cancer by Raez, et al.
Multiple therapies targeting specific genetic alterations have been approved in the last decade, leading to significant improvements in the treatment of NSCLC. While tissue biopsies have traditionally been used for NGS, growing evidence supports using plasma-based ctDNA, also known as “liquid biopsy,” to supplement tissue biopsy approaches in directing first-line therapy.
Retrospective analysis of 170 newly diagnosed cases of NSCLC treated at 2 cancer centers over a 5-year period using tissue and liquid biopsy NGS. Most treatments were determined by liquid biopsy results (73.5%) rather than tissue biopsy (25.9%), according to a treatment schema defined by testing adequacy, biomarker detection, and turnaround time (TAT). Results from liquid biopsy NGS were reported to be higher in success rate and returned on average 26.8 days faster than tissue. Liquid biopsies showed between 94.8 and 100% concordance with tissue samples for guideline-recommended biomarkers.
Biomarkers recommended by guidelines were found in 76.5% of patients using a liquid-first approach and 54.9% using a tissue-first approach. Neither the time it took to begin treatment nor the survival rates (both overall and progression-free) were significantly different between those who had a liquid biopsy and those who had a tissue biopsy. According to these findings, liquid biopsy NGS is useful for detecting clinically relevant genetic alterations in NSCLC. To make treatment decisions in NSCLC, liquid biopsy can be used either as a first-line test or concordantly with tissue biopsy due to its high concordance to tissue, faster TAT, and similar outcomes and time to treatment.
Source: sciencedirect.com/science/article/abs/pii/S1525730422002650