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Palmieri et al. J Cancer Metastasis Treat 2020;6:55 I http://dx.doi.org/10.20517/2394-4722.2020.105 Page 7 of 8

in tumor progression, showing further reduction of the number of clones, or a new increase of “random”
mutations.

In conclusion, additional study in larger series is required for further confirmation of these preliminary
data and suggestions. A greater use of liquid biopsy is recommended for proper detection of genetic
mutations and for “the right treatment in the right patient at the right time”.

DECLARATIONS
Acknowledgments
Authors thank the support from the Regione Toscana - Istituto Toscano Tumori (ITT) (Project
“Identification of genetic bases of individual predisposition to lung cancer in non-smokers”) and the ASSO
(Associazione per lo Sviluppo della Scienza Oncologica) Onlus. This work was, in part, supported by the
MIUR project “Dipartimenti di Eccellenza 2018-2022” to the Department of Medical Biotechnologies,
University of Siena”. This work is generated within the ERN-EURACAN (European network for Rare Adult
Aolid Cancer).

Authors’ contributions
Performed the experiments, analyzed the data and wrote the paper: Palmieri M
Performed the experiments: Iuso N
Wrote the paper: Cetta F
Analyzed the data: Fallerini C, Tita R
Took care of the clinical part of the study: Fava F, Fabbiani A
Performed genetic counseling and provided patient samples: Baldassarri M, Mencarelli MA
Designed the research strategy, analyzed the data, and wrote the paper: Renieri A, Frullanti E.

Availability of data and materials
The data that support the findings of this study are available from the corresponding author upon
reasonable request.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
The consent to participate was obtained from patients included in the study.

Consent for publication
The consent for publication was obtained from patients included in the study.

Copyright
© The Author(s) 2020.

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