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. 2023 Jul 25;6(7):e2325332. doi: 10.1001/jamanetworkopen.2023.25332

Figure 3. Plasma-First Approach Proposed Algorithm.

Figure 3.

ctDNA indicates circulating tumor DNA; NGS, next-generation sequencing; and PD-L1, programmed cell death ligand 1.

aPrioritize tissue sampling (required), pathologic diagnosis, and subtyping (if possible) prior to treatment initiation based on ctDNA results.

bSome may consider tissue NGS testing optional in this scenario as the frequency of actionable coalterations is uncommon in the presence of another driver alteration.