4. Discussion
In the future, liquid biopsy will be used either as a surrogate or
alternative to tissue biopsy or as valid tool to decide among
therapeutic issues.
Observational data suggest that liquid biopsy is able to highlight
predictive progression signals. This potential may be developed on a
technical level in facilities characterized by strong methodological
experience and a high availability of technologies; these centers are
often configured as HUBs. In oncological networks, having a predictive
diagnostic HUB means to have the capability of strengthening the
appropriateness of the diagnostic and therapeutic path. Figure 2 shows
the resolution capability of the methodology used in the study; that
could integrate the overall risk assessment. The research is also
focusing on other research protocols for innovative molecular tests.9,13
When, in fact, patients respond to treatment with EGFR inhibitor drugs a
reduction in blood mutation levels is observed and the liquid biopsy
could confirm this process quickly and effectively.7integrating prognosis information. In fact, where there is a residual
disease liquid biopsy may establish the risk of recurrence.14.
To obtain a greater prognostic accuracy, especially in the minimal
residual disease evaluation, it may be appropriate to proceed to an
analysis of the prognostic and predictive weight for both either the
single mutations ,or their modular combinations.
A significant limit, to reach this goal, is the lack of complete digital
health file where all the information related to the treatment path may
be connected. Nevertheless, the data presented evidenced the potential
of liquid biopsy, as a predictive measure of tissue progression and
therefore of tertiary prevention. The value of targeted screening is
crucial for identifying decision steps and directing the treatment
pathway (Fig 1). In the context of lung cancer, but also in other
similar pathologies the definition of screening markers can foresee the
following steps of care.