Liquid biopsy





High sensitivity and specificity

Invasive and limited use in patients with poor performance status and inaccessible tumor sites

Less invasive and can be used in patients with poor performance status and inaccessible tumor sites

Risk of false-positive results are more

Histological transformations and subtyping are possible

Turnaround time is more

Turnaround time is less compared to tissue biopsy

Somatic mutations in the plasma due to clonal hematopoiesis hamper the result

Confirmation on metastases/relapse

Complete genomic alterations are not visible due to tumor heterogeneity

Sources of DNA, such as blood, serum, plasma, saliva, or urine can be analyzed for molecular alterations

Test sensitivity challenges still exist due to the relatively low level of circulating tumor cells or DNA

Tumor microenvironment can be checked

Tissue biopsy from a metastatic site may not explain the real nature of the primary tumor

Reported > 90% concordance with tissue re-biopsy

Histologic transformations are difficult to find

Immunohistochemistry is cheaper than molecular techniques in assessing biomarkers such as PDL-1

Preservation methods such as formalin fixation can result in false-positive results in molecular assays

It can be easily repeated if needed and can be used as often as necessary to monitor the patient’s progress

Very expensive as compared to Immunohistochemistry

It can be used to estimate the risk for metastatic relapse or metastatic progression