Optimizing molecular residual disease detection using liquid biopsy postoperatively in early stage lung cancer

Existing postoperative detection methods are limited to microscopic residual disease assessment of the surgical specimen margins (traditional histopathology), and gross disease detection with imaging (positron emission tomography and CT scans) (7). In the context of a clinical trial, blood-based stratification of the study population by presence of genetic alterations for targeted systemic therapy selection is the ideal avenue for introduction of this technology into postoperative clinical practice (13). Matching reference genetic alterations in resected lung tumor tissue with blood plasma sequencing panels also mitigates the problem of false-positive results from clonal hematopoiesis of indeterminate potential (CHIP). Ongoing pilot studies in this setting are essential in efforts to decrease the global burden of disease and mortality due to lung cancer.