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1、TheworldleaderinservingscienceProprietary&Confidential你所需，我所有——肿瘤液体活检方案有ThermoFisher就够了ForResearchUseOnly.Notforuseindiagnosticprocedures2©2016ThermoFisherScientificCorporation.Allrightsreserved.MoleculartestingguidelinesforinformingtreatmentoptionsforNSCLCpatie
2、nts,asrecommendedbyCAP1,AMP1,IASLC1,andNCCN2:EGFR,ALK,ROS1,BRAF,andPDL1testingforfirst-linetherapies2Emergingtargetedagentsforpatientswithothergeneticalterations,includingKRAS,HER2,MET,andRET2Broadermolecularprofilingtoidentifyraredrivermutationsforwhicheffectiv
3、edrugsmaybealreadyavailable,ortoappropriatelycounselpatientsregardingtheavailabilityofclinicaltrials;broadmolecularprofilingisakeycomponentoftheimprovementtocareofpatientswithNSCLC2多基因检测为相关指南所推荐精准治疗方案的制定离不开多基因检测，多种相关指南均建议实体肿瘤患者可尝试多基因检测。JournalofMolecularDiagnost
4、ics,MolecularTestingGuidelineforSelectionofLungCancerPatientsforEGFRandALKTyrosineKinaseInhibitors.GuidelinefromtheCollegeofAmericanPathologists,InternationalAssociationfortheStudyofLungCancer,andAssociationforMolecularPathology15(4),July2013.NCCNClinicalPractic
5、eGuidelinesinOncology(NCCNGuidelines™),Non-SmallCellLungCancer,v8.2017,NCCN.org.Forinvitrodiagnosticuse.实时的肿瘤分子分型有助于选择最为合适的治疗策略Therapy1Therapy2Therapy3EGFRExon19EGFRExon19(20%)EGFRExon19(29%)EGFRExon19(20%)KRASp.G13D(55%)T790M(6%)T790M(2%)METp.N375S(40%)P53p.G24
6、5V(10%)P53p.G245V(3%)METp.T1010I(20%)METp.N375S(59%)METp.N375S(55%)BaselineTime1TBB/TTBTime2Pleuraerguss(90%)Time3Liquidbiopsy(ctDNA)EGFR(Exon19)肿瘤分子分型的时空特异性治疗压力可能会导致肿瘤发Th变异，产Th耐药突变或者驱动基因的改变3©2016ThermoFisherScientificCorporation.Allrightsreserved.ForResearchUse
7、Only.Notforuseindiagnosticprocedures液体活检可作为组织活检的有效补充液体活检非侵入性的实时取样：为需要实时监控疗效的靶向治疗患者提供耐药监测的可能取样容易：为无手术样本或难以穿刺的肿瘤患者提供精准靶向治疗方案的可能4©2016ThermoFisherScientificCorporation.Allrightsreserved.ForResearchUseOnly.NotforuseindiagnosticproceduresNCCNGuideline和CSCO指南的建议中国临床肿瘤
8、学会（CSCO）原发性肺癌诊疗指南2017.V15©2016ThermoFisherScientificCorporation.Allrightsreserved.ForResearchUseOnly.Notforuseindiagnosticprocedures液体活检的临床意义治疗方案选择疗效监控复发监控血液样本、手术样本及术
