4. Discussion
In the future, liquid biopsy will be used either as a surrogate or alternative to tissue biopsy or as valid tool to decide among therapeutic issues.
Observational data suggest that liquid biopsy is able to highlight predictive progression signals. This potential may be developed on a technical level in facilities characterized by strong methodological experience and a high availability of technologies; these centers are often configured as HUBs. In oncological networks, having a predictive diagnostic HUB means to have the capability of strengthening the appropriateness of the diagnostic and therapeutic path. Figure 2 shows the resolution capability of the methodology used in the study; that could integrate the overall risk assessment. The research is also focusing on other research protocols for innovative molecular tests.9,13 When, in fact, patients respond to treatment with EGFR inhibitor drugs a reduction in blood mutation levels is observed and the liquid biopsy could confirm this process quickly and effectively.7integrating prognosis information. In fact, where there is a residual disease liquid biopsy may establish the risk of recurrence.14.
To obtain a greater prognostic accuracy, especially in the minimal residual disease evaluation, it may be appropriate to proceed to an analysis of the prognostic and predictive weight for both either the single mutations ,or their modular combinations.
A significant limit, to reach this goal, is the lack of complete digital health file where all the information related to the treatment path may be connected. Nevertheless, the data presented evidenced the potential of liquid biopsy, as a predictive measure of tissue progression and therefore of tertiary prevention. The value of targeted screening is crucial for identifying decision steps and directing the treatment pathway (Fig 1). In the context of lung cancer, but also in other similar pathologies the definition of screening markers can foresee the following steps of care.