Use of liquid biopsy in monitoring therapeutic resistance in EGFR oncogene addicted NSCLC

Abstract

Liquid biopsy has emerged as a minimally invasive alternative to tumor tissue analysis for the management of lung cancer patients, especially for epidermal growth factor receptor (EGFR) oncogene addicted tumor. In these patients, despite the clear benefits of tyrosine kinase inhibitors therapy, the development of acquired resistance and progressive disease is inevitable in most cases and liquid biopsy is important for molecular characterization at resistance and, being non-invasive, may be useful for disease monitoring. In this review, the authors will focus on the applications of liquid biopsy in EGFR-mutated non small cells lung cancer at diagnosis, during treatment and at progression, describing available data and possible future scenarios.

Adaptive Control of Tumor Growth

“…Considering the example of lung cancer, which is the leading cause of cancer deaths and a prime target for combination therapy, 65 - 69 there is a spur of research interests in the continuous monitoring of therapy using liquid biopsy. 70 - 74 For instance, NSCLC tumors are known to harbor various genetic alterations, implicating EGFR, ALK, MET, ERRB2/3, ROS, BRAF, KRAS, RET, and NRTK, 75 - 77 and corresponding signaling pathways, including RTK-RAS/ERK, PI3K-AKT-MTOR, Genome Integrity (P53-DNA repair), and cell cycle. 78 - 80 Initial genomic profiling of NSCLC tumors at the time of diagnosis would identify actionable genetic alterations and the associated oncogenic signaling network.…”