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Among solid tumors, non-small cell lung cancer (NSCLC) represents the paradigm of the application of precision medicine to clinical practice. Understanding many biomolecular mechanisms in the determinism of NSCLC has ensured the development of small molecules targeting specific genetic mutations with key roles in tumor disease progression. The ATLAS IALSC guidelines recommend carrying out screening for rearrangement of the ALK gene in all patients with advanced NSCLC, mainly for the histological type adenocarcinoma or with an adenocarcinoma component. The use of next generation sequencing (NGS) panels applied to liquid biopsy provides a powerful method for the genetic profiling of NSCLC for both standard treatment options and clinical trials. Liquid biopsy represents a powerful non-invasive methodology to provide clinically useful information in defining the therapeutic process of patients with translocated ALK NSCLC.

The therapeutic approach to the patient with non-small cell lung cancer (NSCLC) has undergone, in the last decade, a profound revolution following the marketing of molecularly targeted drugs. The launch of a vast research activity with the use of next generation sequencing (NGS) applied to liquid biopsy should be underlined. This last methodology, which allows to identify the correct biomolecular structure of the neoplastic population, has achieved significant progress in the effective implementation of personalized medicine. Nevertheless, the liquid biopsy represents a useful diagnostic strategy in those patients in whom a rebiopsia is difficult for technical reasons or for the patient's health conditions. The liquid biopsy represents a substantial cultural revolution opening a scenario in the identification of molecular drivers in the treatment of lung neoplasms.