Advances in liquid biopsy-based markers in NSCLC

Efficacy of liquid biopsy for genetic mutations determination in non-small cell lung cancer: a systematic review on literatures

BACKGROUND

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related mortality worldwide and is often diagnosed at advanced stages, limiting treatment options. This systematic review aims to evaluate the efficacy of liquid biopsy in detecting genetic mutations in NSCLC, focusing on its sensitivity, specificity, clinical utility, and potential to guide personalized treatment strategies.

METHODS

A systematic search was conducted in PubMed, Scopus, Embase, Web of Science, and Cochrane Library to identify relevant studies published between 1990 and September 2024. Eligible studies included comparative analyses of liquid biopsy techniques for NSCLC diagnosis, prognosis, progression, or treatment response. This review adheres to the PRISMA 2020 guidelines and assesses study quality using the QUADAS framework.

RESULTS

A total of 30 studies were included. Digital droplet PCR (ddPCR) demonstrated the highest sensitivity, detecting low-frequency mutations such as EGFR T790M at levels as low as 0.01%. Next-generation sequencing (NGS) provided comprehensive mutational profiling, revealing tumor heterogeneity and co-existing mutations but required high-quality plasma samples. The cobas EGFR Mutation Test, while less sensitive than ddPCR, remains widely used due to its clinical accessibility. Emerging methods, including extracellular vesicle analysis, show promise but require further validation. Additionally, liquid biopsy effectively identified non-EGFR mutations, such as KRAS, ALK, and MET amplifications, expanding its clinical applicability.

CONCLUSION

Liquid biopsy is a transformative tool in NSCLC management, offering a minimally invasive approach for mutation detection, disease monitoring, and treatment guidance. Future research should focus on multicenter trials and emerging technologies to enhance clinical integration and broaden applicability across different cancer types.

SERS microfluidic chip integrated with double amplified signal off-on strategy for detection of microRNA in NSCLC

In this work, based on Fe3O4@AuNPs and double amplified signal Off-On strategy, a simple and sensitive SERS microfluidic chip was constructed to detect microRNA associated with non-small cell lung cancer (NSCLC). Fe3O4@AuNPs have two advantages of SERS enhanced and magnetic adsorption, the introduction of microfluidic chip can realize double amplification of SERS signal. First, the binding of complementary ssDNA and hpDNA moved the Raman signaling molecule away from Fe3O4@AuNPs, at which point the signal was turned off. Second, in the presence of the target microRNA, they were captured by complementary ssDNA and bound to them. HpDNA restored the hairpin conformation, the Raman signaling molecule moved closer to Fe3O4@AuNPs. At this time, the signal was turned on and strong Raman signal was generated. And last, through the magnetic component of SERS microfluidic chip, Fe3O4@AuNPs could be enriched to realize the secondary enhancement of SERS signal. In this way, the proposed SERS microfluidic chip can detect microRNA with high sensitivity and specificity. The corresponding detection of limit (LOD) for miR-21 versus miR-125b was 6.38 aM and 7.94 aM, respectively. This SERS microfluidic chip was promising in the field of early detection of NSCLC.