Rebuttal from Dr. Mino-Kenudson

First of all, I would like to congratulate Drs. Ilie and Hofman for their excellent discussion in support of the possibility of liquid biopsy to replace tissue biopsy. As they accurately pointed out, if validated for routine clinical use, liquid biopsy would overcome the following issues inherent to tissue biopsy: (I) inability of capturing the complete genomic landscape of the non-small cell lung cancer (NSCLC) patient that is attributed to inter- and intratumoral heterogeneity and/or often limited tumor accessibility due in part to poor performance status of the advanced NSCLC patient limiting the role of interventional procedures (1); (II) insufficient quantity and quality of tissue hampering molecular testing, in particular next generation sequencing (NGS) (2); (III) potential false positive results due to high levels of artificial C>T/G>A transitions induced by preservation methods such as formalin fixation (3); (IV) high cost of biopsy/FNA procedure and turn-around-time longer than expected.