ALK determination: Liquid and tissue biopsy. Comparing techniques and effectiveness of alectinib in a controversial clinical case [Determinazione di ALK: Tra biopsia liquida e tissutale. Tecniche a confronto ed efficacia di alectinib in un caso clinico controverso]

The next generation sequencing (NGS) applied to liquid biopsy is useful to determine the biomolecular identity of the prevalent neoplastic cell population. The sensitivity of ALK detection in liquid biopsy is comparable to that showed by the gold standard tissue biopsy and its usefulness is demonstrated in clinical practice by the similar efficacy of ALK TKIs to obtain prolonged disease control. ALK ve+ lung cancer today presents a large number of therapeutic opportunities leading to a long/term survival. Correct evaluation of ALK translocation is a paramount in order to guide the correct therapeutic strategy as illustrated in the present clinical case.