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Liquid Biopsy NSCLC — SCE Medical Oncology MCQ

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EasyLung CancerLiquid Biopsy NSCLCSCE Medical Oncology

A 60-year-old man with metastatic NSCLC has a tissue biopsy that is insufficient for molecular profiling. What alternative approach can provide comprehensive molecular information?

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Correct answer: E — Liquid biopsy (ctDNA) via blood sample — comprehensive next-generation sequencing of ctDNA can identify EGFR, ALK, ROS1, BRAF, KRAS, MET, RET, NTRK and other alterations when tissue is insufficient

When tissue biopsy is insufficient or unavailable for molecular testing in NSCLC, ctDNA liquid biopsy provides a non-invasive alternative for detecting actionable genomic alterations. FDA-approved ctDNA panels (Guardant360, FoundationOne Liquid CDx) can identify EGFR, ALK, ROS1, BRAF, KRAS G12C, MET, RET, NTRK and other alterations. Sensitivity is approximately 70-85% for clonal alterations. A negative ctDNA result should prompt tissue re-biopsy if clinical suspicion is high (false-negative rate ~15-30%).

Reference: ESMO 2024 NSCLC; NICE NG122; ESMO Liquid Biopsy Recommendations 2024