Liquid First Is “Solid” in Naïve Non-Small Cell Lung Cancer Patients: Faster Turnaround Time With High Concordance to Solid Next-Generation Sequencing

Abstract

PurposeMolecular profiling is crucial in naïve non-small cell lung cancer (NSCLC). While tissue-based analysis is challenged by turnaround time and scarcity of tissue, there is increasing demand for liquid biopsy. We aimed to analyze the use of upfront liquid biopsy as a molecular profiling approach.MethodsThis retrospective multicenter, non-interventional study compared findings and turnaround times of liquid vs. standard-of-care (SOC) tissue-biopsy molecular profiling. The study included naïve advanced NSCLC patients with available liquid biopsy (Guardant360 CDx).ResultsA total of 42 consecutive patients (60% men; median age, 69.5 [39–87] years; 86% stage IV NSCLC) were identified between September 2017 and December 2020. Liquid-biopsy analysis provided results for all 42 patients, whereas the tissue-based analysis failed in 5 (12%) patients due to insufficient tumor samples. In 17 patients, 18 actionable driver mutations were identified. Eleven mutations were detected by both approaches (i.e., concordance of 61%), 4 only by liquid biopsy and 3 only by tissue biopsy. The median time from the molecular request to receiving the molecular solid report on the last biomarker was 21 (range: 5–66) days, whereas the median time from blood draw to the liquid-biopsy results was 10.5 (7–19) days. The median time between the availability of liquid-biopsy findings and that of the last biomarker was 5 days. Treatment changes following the liquid-biopsy results were observed in 3 (7%) patients.ConclusionPerforming liquid-biopsy upfront is feasible and accurate and allows a shorter time for treatment in NSCLC, especially when tumor tissue is scarce.

Liquid Biopsy in Early-Stage Lung Cancer: Current and Future Clinical Applications

“…A prospective study in 282 patients with untreated metastatic NSCLC demonstrated that ctDNA analysis identified oncogenic variants on average 6 days before standard-of-care tissue genotyping, resulting in 9 versus 16 days of turnaround time (TAT) and thereby shortening the time to treatment significantly (median 18 days with liquid biopsy vs. 31 days with tumor tissue molecular profiling, p = 0.0008) [11]. These results were in line with a retrospective analysis, showing a median TAT in favor of LB [22,23]. The time between the molecular analysis request on a tissue biopsy and receiving the molecular report on the last biomarker was on average 21 (range 5-66) days.…”

Can Liquid Biopsy Based on ctDNA/cfDNA Replace Tissue Biopsy for the Precision Treatment of EGFR-Mutated NSCLC?

“…In terms of detection timelines, Sehayek et al compared the results and turnaround times of the molecular analysis of liquid and tissue biopsies, and found that liquid biopsies had consistent analytical results and shorter turnaround times. This means that liquid biopsy is feasible and accurate and can shorten the time required to diagnose NSCLC, especially when tumor tissues are scarce [ 41 ]. It is noteworthy that although NGS is widely touted as being more sensitive than qPCR, the available evidence suggests that all commonly used ctDNA detection techniques lack satisfactory sensitivity (e.g., qPCR, ddPCR, and NGS) [ 42 ].…”