Table 1.

Current recommendations for ctDNA analysis in solid tumours.

	IASLC	ASCO/CAP	ESMO NSCLC	NCCN – NSCLC	NCCN- Breast cancer	NCCN—Oesophageal, EJG, and gastric	NCCN - Melanoma
Plasma over serum	✓	✓
Prioritise histologic diagnosis	✓	✓		✓
If tissue insufficient, medically unfit, or expected delay, consider plasma testing	✓			✓		✓	✓
Plasma genotyping at progression to detect targetable alteration	✓	✓	✓	✓	✓	✓
If plasma negative, tissue biopsy recommended	✓	✓	✓	✓	✓	✓
A positive, actionable ctDNA-detected alteration is sufficient to initiate treatment	✓	✓	✓	✓	✓	✓
NGS is preferred for detecting fusions	✓
Reports to include platform used and molecular findings	✓	✓
Establish analytical validity of each assay	✓	✓		✓
Account for CHIP-related alterations	✓	✓		✓

Check marks indicate recommendations based on NCCN guidelines (tumour-specific).

NSCLC non-small cell lung cancer, CHIP Clonal hematopoiesis of indeterminate potential, EGJ Esophagogastric, IASLC International Association for the Study of Lung Cancer, ESMO European Society for Medical Oncology, ASCO/CAP American Society of Clinical Oncology, College of American Pathologists.