The IASLC released guidance on the use of biopsies for the detection of EGFR and other tumor mutations in patients with NSCLC.

The Worldwide Affiliation for the Examine of Lung Most cancers (IASLC) has launched suggestions for the usage of liquid biopsies to tell the care of sufferers with superior non-small cell lung most cancers (NSCLC), providing steerage on the scientific assortment, processing, and genetic evaluation of tumor DNA from peripheral plasma samples.1
These exams can be utilized for preliminary molecular prognosis and for detection of acquired drug resistance mutations. 
“Liquid biopsy and its subsequent molecular analysis is a powerful tool that can determine the patient’s molecular tumor profile in order to determine the best therapeutic option and can be applied as an alternative to tissue testing in cases where tumor testing is not possible or tissue is not adequate,” reported assertion coauthor Fred Hirsch, MD, PhD, the chief govt officer of the IASLC, in a press launch.2

Circulating tumor DNA (ctDNA)-based gene exams for EGFR mutations are already used and exams for ALK and different mutations will quickly observe, the authors famous. Different liquid biopsy strategies are in growth, together with ones that seize circulating tumor cells, platelet RNA, and ctRNA, however these aren’t but validated or effectively understood. 

“The IASLC Statement was very comprehensive,” mentioned Edward S. Kim, MD, Chair of Strong Tumor Oncology on the Levin Most cancers Institute in Charlotte, North Carolina, who was not an creator of the assertion paper.
“[The statement] gives guidance around the world about everything from how to collect the specimens to how to process them, the acceptable platforms to run them on and which types of driver alterations or biomarkers are best utilized, or with which we have the most experience,” he continued.
The IASLC assertion recommends that liquid biopsies be obtained from sufferers for whom it is extremely troublesome or dangerous to carry out conventional tumor tissue biopsy. Biopsying metastatic bone tumors could be difficult, for instance.
“It’s a natural segue from tissue to blood or serum to help us diagnose patients, determine treatment recommendations using biomarkers, and also assess if a therapy should be continued or stopped,” Dr Kim mentioned. “Down the road, we may be able [use liquid biopsy] to avoid overtreatment of patients.”
The multidisciplinary crew of authors beneficial the usage of “double-spin” plasma isolation and plasma-extracted ctDNA testing, and that plasma extraction happen inside 2 hours of blood draw when EDTA tubes are used, or three days for preservative tubes. Blood ought to by no means be frozen earlier than plasma extraction, they famous. Two customary 10 mL tubes must be used at blood draw. Validated, quantitative PCR (qPCR)-based evaluation of EGFRand different focused mutations is “acceptable,” the authors concluded.

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