Current Thoracic Surgery

Lung cancer exhibits the highest mortality rate of all malignant tumors, and only a minority of non-small cell lung cancer (NSCLC) patients are diagnosed with localized, early stage tumors. Unfortunately, NSCLC is usually detected at advanced and inoperable stages. Tumor biomarkers can detect early stage lung cancer independently or in combination with low-dose computed tomography-based screening techniques. A liquid biopsy is a noninvasive modality for the pathological and molecular characterization of cancer, and it can be isolated from bodily fluids. There are a variety of biological elements that can be isolated from the peripheral blood, such as exosomes, circulating cell-free (tumor) DNA, circulating tumor cells, and microRNA. A liquid biopsy can be used to detect somatic mutations before treatment and dynamically during treatment, and to monitor the treatment response. It can also be used for minimal residual disease quantification, and to determine the emergence of therapy resistance. Despite the numerous research studies showing successful results, clinically available lung cancer biomarkers do not have sufficiently high specificity and sensitivity for widespread use. Therefore, universal experimental and therapeutic research regarding advanced molecular diagnostics has become necessary.