ABSTRACT

Lung cancer is the most common reason of cancer deaths. Many of lung cancer cases are diagnosed at advanced stage. Lung adenocarcinomas are the most frequent type of lung cancer. Somatic genetic alterations, including mutations, rearrangements, amplifications, which are necessary for oncogenesis, are especially frequent in lung adenocarcinoma.According to current practice guidelines, all patients with advanced non-small cell lung cancer should undergo molecular testing. For lung adenocarcinoma, all patients with advanced disease should undergo testing for EGFR mutations, ALK and ROS1 rearrangements, to predict response to EGFR, ALK, or ROS1 targeted inhibitors. In addition to these, some other molecular alterations are under investigation as predictors of response to targeted therapies or predictors of acquired drug resistance including BRAF, ERBB2 mutations or amplification, MET mutations and amplification, and RET gene rearrangements. Immune checkpoint inhibitors of PD-1/PD-L1 pathway having a role in the therapy of pulmonary non-small cell carcinoma are one of the most popular oncological developments in last years. By detecting PD-L1 expression of tumor cells/tumor infiltrating immune cells, the most suitable patients for immunotherapy can be defined. Liquid biopsy is a sample usually taken from peripheral blood of patients with lung cancer. Circulating tumor cells and circulating tumor DNA obtained from liquid biopsy can be used for patients in diagnostic procedures and molecular tests.