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Update on molecular pathology and role of liquid biopsy in nonsmall cell lung cancer

机译：液体活检在非物质细胞肺癌中的分子病理学及作用的更新

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Personalised medicine, an essential component of modern thoracic oncology, has been evolving continuously ever since the discovery of the epidermal growth factor receptor and its tyrosine kinase inhibitors. Today, screening for driver alterations in patients with advanced lung adenocarcinoma as well as those with squamous cell carcinoma and no/little history of smoking is mandatory. Multiplex molecular platforms are preferred to sequential molecular testing since they are less time- and tissue-consuming. In this review, we present the latest updates on the nine most common actionable driver alterations in nonsmall cell lung cancer. Liquid biopsy, a simple noninvasive technique that uses different analytes, mostly circulating tumour DNA, is an appealing tool that is used in thoracic oncology to identify driver alterations including resistance mutations. Additional roles are being evaluated in clinical trials and include monitoring the response to treatment, screening for lung cancer in high-risk patients and early detection of relapse in the adjuvant setting. In addition, liquid biopsy is being tested in immune-oncology as a prognostic, predictive and pharmacodynamic tool. The major limitation of plasma-based assays remains their low sensitivity when compared to tissue-based assays. Ensuring the clinical validity and utility of liquid biopsy will definitely optimise cancer care.
机译：个人医学是现代胸部肿瘤学的一个基本组成部分，自表皮生长因子受体和酪氨酸激酶抑制剂发现以来一直在不断发展。如今，筛查肺腺癌患者的司机改变以及鳞状细胞癌的患者，并且不适用于吸烟的历史。多重分子平台优选为连续的分子检测，因为它们较少时间和组织耗材较少。在这篇综述中，我们提出了关于NONEMALL细胞肺癌中九个最常见的可操作驾驶员改变的最新更新。液体活检，一种使用不同分析物，大多循环肿瘤DNA的简单的非侵入性技术是一种吸引工具，用于胸部肿瘤，以识别包括抗性突变的驾驶员改变。在临床试验中正在评估其他角色，包括监测对治疗的响应，高危患者的肺癌和早期检测佐剂设置中复发的筛选。此外，在免疫肿瘤学中测试液体活检作为预后，预测和药效动物工具。与基于组织的测定相比，基于等离子体基测定的主要限制仍然是它们的低灵敏度。确保液体活检的临床有效性和效用肯定会优化癌症护理。

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