Obtaining a biopsy of solid
tumors requires invasive procedures that strongly limit patient compliance. In contrast, a blood extraction is safe, can be performed at many time points during the course disease and encourages appropriate
therapy modifications, potentially improving the patient's clinical outcome and quality of life. Fusion of the
tyrosine kinase genes
anaplastic lymphoma kinase (ALK), C-ROS
oncogen 1 (ROS 1), rearranged during transfection (RET) and neurotrophic
tyrosine kinase 1 (NTRK1) occur in 1-5% of
lung adenocarcinomas and constitute therapeutic targets for
tyrosine kinase inhibitors. In addition, a MET splicing variant of exon 14, has been reported in 2-4% of
lung adenocarcinoma and recent studies suggests that targeted
therapies inhibiting MET signaling would be beneficial for patients with this alteration. In this review, we will summarize the new techniques recently developed to detect ALK, RET, ROS and NTRK1 fusions and MET exon 14 splicing variant in liquid biopsy using plasma, serum,
circulating tumor cells (CTCs), platelets and exosomes as starting material.