OBJECTIVES: The aim of this study was to conduct a systematic review and a meta-analysis in order to determine the accuracy of next generation sequencing (NGS) panel using circulating tumor DNA (ctDNA) to detect known actionable oncogenic driver alterations in patient with advanced non-small cell lung cancer (aNSCLC).

METHODS: MEDLINE/PubMed, Cochrane library, LILACS and Centre for Reviews and Dissemination databases and articles obtained from other sources were searched for relevant studies that evaluate the accuracy (sensitivity and specificity) of NGS using ctDNA in patient with aNSCLC. The studies were eligible when NGS of ctDNA was compared with tissue tests to detect at least one of the following oncogenic driver alterations: EGFR, ALK, ROS-1 and BRAF. Diagnostic measures (sensitivity and specificity) were pooled with a bivariate diagnostic random-effect. All statistical analyses were performed with R-package mada.

RESULTS: Seven studies were eligible for data extraction. The overall pooled estimates of sensitivity, specificity and area under curve were 78.1% (95% confidence interval, 66.3% to 86.6%); 98.2% (95% confidence interval, 93.9% - 99.5%); 94.8%, respectively.

CONCLUSIONS: The analysis has demonstrated that the NGS panel of ctDNA has a high accuracy to identify the four actionable oncogenic driver alterations in patient with aNSCLC.