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During the last decades, genetic characterization of tumors has gained an increasing role in the development of new systemic treatments and one of the most commonly recognized needs in modern oncology is to use molecular characterization to tailor therapy. In many malignancies, but especially in non-small cell lung cancer (NSCLC), therapeutic algorithms are shaped based on genetic characterization and identification of driver alterations, which can be targeted with highly specific drugs (1). The current paradigm in precision oncology is that the more accurate we are in defining the disease, the best treatment we can administer to the patient in terms of efficacy, duration of clinical benefit and survival. This common ground is slowly but firmly pushing techniques for broad genetic characterization into daily practice of NSCLC. Next generation sequencing (NGS) allows screening of a large number of genetic alterations simultaneously and advanced stage disease is the first setting in which such analyses are currently applied.

Assessment of chromosomal rearrangements helps to differentiate multiple lung primary cancers from metastases