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Journal of Oncology
Volume 2017 (2017), Article ID 4517834, 5 pages
https://doi.org/10.1155/2017/4517834
Review Article

Capturing Genomic Evolution of Lung Cancers through Liquid Biopsy for Circulating Tumor DNA

1Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
2Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, CA 94305, USA
3Stanford Cancer Institute, Stanford University, Stanford, CA 94305, USA
4Department of Radiation Oncology, Stanford University, Stanford, CA 94305, USA
5Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
6Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA

Correspondence should be addressed to Bob T. Li

Received 6 January 2017; Accepted 28 February 2017; Published 14 March 2017

Academic Editor: Subodh Kumar

Copyright © 2017 Michael Offin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Genetic sequencing of malignancies has become increasingly important to uncover therapeutic targets and capture the tumor’s dynamic changes to drug sensitivity and resistance through genomic evolution. In lung cancers, the current standard of tissue biopsy at the time of diagnosis and progression is not always feasible or practical and may underestimate intratumoral heterogeneity. Technological advances in genetic sequencing have enabled the use of circulating tumor DNA (ctDNA) analysis to obtain information on both targetable mutations and capturing real-time Darwinian evolution of tumor clones and drug resistance mechanisms under selective therapeutic pressure. The ability to analyze ctDNA from plasma, CSF, or urine enables a comprehensive view of cancers as systemic diseases and captures intratumoral heterogeneity. Here, we describe these recent advances in the setting of lung cancers and advocate for further research and the incorporation of ctDNA analysis in clinical trials of targeted therapies. By capturing genomic evolution in a noninvasive manner, liquid biopsy for ctDNA analysis could accelerate therapeutic discovery and deliver the next leap forward in precision medicine for patients with lung cancers and other solid tumors.