Non-small cell lung cancer is one leading cause of death worldwide, and patients would greatly benefit from an early diagnosis. Since targeted and immunotherapies have emerged as novel approaches for more tailored treatments, repeated assessments of the tumor biology have become pivotal to drive clinical decisions. Currently, tumor tissue biopsy is the gold standard to investigate potentially actionable biomarkers, but this procedure is invasive and may prove inadequate to represent the whole malignancy. In this regard, liquid biopsy represents a minimally invasive and more comprehensive option for early detection and investigation of this tumor. Today, cell-free DNA is the only approved circulating marker to select patients for a targeted therapy. Conversely, the other tumor-derived markers (i.e., circulating tumor cells, miRNAs, exosomes, and tumor educated platelets) are still at a pre-clinical phase, although they show promising results for their application in screening programs or as prognostic/predictive biomarkers. The main challenges for their clinical translation are the lack of reliable cutoffs and, especially for miRNAs, the great variability among the studies. Moreover, no established tool has been approved for circulating tumor cells and exosome isolation. Finally, large prospective clinical trials are mandatory to provide evidence of their clinical utility.

Original languageEnglish
Article number17
Issue number1
Publication statusPublished - 2020


  • CfDNA/ctDNA
  • Circulating miRNA
  • Exosomes
  • Liquid biopsy
  • Prognostic/predictive biomarkers
  • Tumor educated platelets
  • afatinib
  • anaplastic lymphoma kinase
  • B Raf kinase
  • circulating cell free DNA
  • crizotinib
  • DNA
  • epidermal growth factor receptor
  • epidermal growth factor receptor 2
  • gefitinib
  • HER3 protein
  • microRNA
  • microRNA 126 3p
  • microRNA 145
  • microRNA 155 5p
  • microRNA 18a
  • microRNA 191
  • microRNA 21 5p
  • microRNA 223 3p
  • microRNA 28 3p
  • microRNA 30d
  • microRNA 328
  • microRNA 486
  • microRNA 499
  • programmed death 1 ligand 1
  • protein Ret
  • rociletinib
  • ROS1 protein
  • scatter factor receptor
  • tumor marker
  • unclassified drug
  • unindexed drug
  • angiogenesis
  • cancer prognosis
  • cancer recurrence
  • circulating tumor cell
  • diagnostic accuracy
  • droplet digital polymerase chain reaction
  • EGFR gene
  • epithelial mesenchymal transition
  • exosome
  • gene expression
  • gene mutation
  • gene rearrangement
  • human
  • liquid biopsy
  • lung adenocarcinoma
  • lung cancer
  • mutational analysis
  • next generation sequencing
  • non small cell lung cancer
  • overall survival
  • point mutation
  • progression free survival
  • protein expression
  • real time polymerase chain reaction
  • Review
  • sensitivity and specificity
  • thrombocyte
  • time to treatment failure
  • treatment failure
  • tumor educated platelet


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