For NSCLC patients with limited diagnostic tissue that is insufficient for genetic testing, do you offer repeat biopsy (of accessible site), blood based testing, or both to evaluate for actionable driver mutations?   

If a patient has insufficient tissue for molecular testing, I will immediately send a liquid biopsy while simultaneously setting up a repeat biopsy. Our blood-based testing returns within 5-7 days. If a driver mutation is found on liquid biopsy, I will cancel the repeat tissue biopsy. If no driver m...

If the patient is willing, a biopsy can be safely done and a treatment decision is not urgently needed, I prefer tissue biopsy for the following reasons: Tissue is the issue. Not infrequently, a different diagnosis was yield upon bx. Tissue testing can be more comprehensive and often required by...

I check both: liquid and tissue concurrently from the very beginning. Many times, tissue is diagnostic for, let’s say, adenocarcinoma but insufficient for NGS testing. By sending both concurrently from the get-go, we may already have an answer if a driver is identified in about a week from the...