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This routine clinical practice of tissue diagnosis imposes several barriers and delays in turnaround time (TAT) for biomarker testing, significantly delaying the time to treatment. The objective of this study is to investigate the \u2018plasma first\u2019 approach for detection of <jats:italic>EGFR<\/jats:italic> mutation in advanced stage treatment na\u00efve NSCLC patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We prospectively collected blood samples of treatment na\u00efve patients with clinical and radiological suspicion of advanced stage NSCLC prior to obtaining tissue biopsy. Plasma cfDNA was tested for <jats:italic>EGFR<\/jats:italic> mutation using two different methods. We compared the sensitivity and TAT of liquid biopsy with tissue biopsy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, we analyzed plasma cell-free DNA (cfDNA) of 236 patients suspected of having advanced NSCLC for <jats:italic>EGFR<\/jats:italic> mutations. We observed a notably shorter turnaround time (TAT) of 3 days, which was significantly quicker compared to the 12-day TAT for tissue biopsy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The ddPCR method had a sensitivity of 82.8%, which was higher than 66.34% sensitivity of ARMS-PCR. The current study also highlights that there is no significant difference in the clinical outcome of the patients whether treated based on liquid biopsy only or tissue biopsy (median progression-free survival of 11.56 vs. 11.9 months; <jats:italic>p<\/jats:italic>\u2009=\u20090.94).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Utilizing a \u2018plasma first\u2019 strategy, given its shorter turnaround time, strong positive concordance and comparable outcomes to tissue biopsy, emerges as a highly specific and reliable method for detecting <jats:italic>EGFR<\/jats:italic> mutations in advanced-stage NSCLC.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00432-024-05828-w","type":"journal-article","created":{"date-parts":[[2024,7,27]],"date-time":"2024-07-27T09:01:25Z","timestamp":1722070885000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["\u2018Plasma first\u2019 approach for detecting epidermal growth factor receptor mutation in advanced non-small cell lung carcinoma"],"prefix":"10.1007","volume":"150","author":[{"given":"Amber","family":"Rathor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhat Singh","family":"Malik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranay","family":"Tanwar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin","family":"Khurana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemavathi","family":"Baskarane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepam","family":"Pushpam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruna","family":"Nambirajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5315-9814","authenticated-orcid":false,"given":"Deepali","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,27]]},"reference":[{"issue":"2","key":"5828_CR22","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1001\/jamaoncol.2018.4305","volume":"5","author":"C Aggarwal","year":"2019","unstructured":"Aggarwal C et al (2019) Clinical implications of plasma-based genotyping with the delivery of personalized therapy in metastatic non-small cell Lung Cancer. 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