Table 1.

Advantages of using next-generation sequencing (NGS) with circulating free (cf) nucleic acids extracted from blood samples at diagnosis of non-small cell lung carcinoma.

Screening of many genomic alterations on several genes at the same time with a noninvasive, painless and repeatable approach

Can be done in a complementary manner or as an alternative to a tissue biopsy

Can be the only option for genomic alteration assessment in certain patients with no possibility of doing a tissue biopsy

Can be the only option for genomic alteration assessment in the case of a low quality and/or quantity of extracted nucleic acid from a tissue sample

The turnaround time (TAT) for NGS results with cf-nucleic acid is faster than for NGS from nucleic acid extracted from a tissue biopsy

NGS of blood samples is globally and indirectly cost effective compared to NGS from a tissue biopsy since avoiding patient hospitalization

NGS of blood samples can reflect the molecular status of different tumor sites at the same time

NGS of blood samples taken with EDTA buffer tubes can avoid artifacts associated with DNA deamination due to the effect of the formalin fixative

Evaluation of the tumor mutation burden (TMB) using NGS with blood samples can integrate the TMB heterogeneity from different tumor sites and at the same time

NGS with a liquid biopsy can allow an increase in the number of patients included into clinical trials at diagnosis