Technological advances, in particular the development of high-throughput sequencing, have led to the emergence of new generation molecular tumor biomarkers. These new tools have profoundly changed therapeutic management in oncology based on precise molecular characterization of tumors and therefore improved personalized therapeutic targeting. Detection of circulating tumor cells, circulating tumor DNA or exosomes in blood samples –so-called “liquid biopsies”– can now provide a genetic snapshot of the patient’s tumor through an alternative and less invasive procedure compared to « solid » biopsies of the tumor tissue itself.

Specifically, in lung cancer context, molecular characterization of non-small cell lung cancer (NSCLC) has allowed a better classification of NSCLC tumors, permitting the introduction of personalized therapies that reduce toxicity and increase survival rates. Tumor tissue analysis remains the gold standard to molecularly stratify advanced NSCLC patients to select TKI treatment, but cell-free DNA (cfDNA) analysis is now recommended when the tissue biopsy is not available or insufficient. Moreover, cfDNA from plasma is more informative than tissue analysis since it captures the heterogeneity of the tumor. Levels of cfDNA are significantly elevated in cancer patients and are associated with disease prognosis and relapse.

In summary, this process of characterizing and real time disease-monitoring can facilitate the research of possible relapses, prevent the emergence of therapy resistance, and contribute to the emanation of a newly therapeutic targets. In the long term, it might also provide a means of early detection of cancer. These new approaches require the treatment of increasing amounts of clinical data, notably, with the goal of calculating both clinical and biological predictive scores. The use of artificial intelligence will be unavoidable in this domain, but it would raise ethical questions about consequences on the health-care system.

Chair/Moderator: Dr. Ashlin Rampul

Chair/Moderator: Dr. Sean Campbell

Talk 1: "Moving towards personalized oncology: the current and future contributions of liquid biopsies" - Dr. Jérôme Alexandre Denis

Talk 2: "Analysis of cfDNA in non-small cell lung cancer diagnosis" - Dr. José Manuel González de Aledo Castillo

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