In addition to the ALK rearrangements, other fusion transcripts of the genes for ROS proto-oncogene 1 (ROS1), ret-proto-oncogene (RET) or NTRK genes have been identified in 1–2% of patients with advanced stage lung cancer. These genomic alterations are liable to be associated with targeted therapies. In this context, NGS approaches were developed to identify these genomic alterations in purified free nucleic acids in blood samples . Based on the hybrid-capture approach, these techniques not look only for rearrangements but also point mutations, insertions, deletions and variations in the number of copies. At present, the NGS techniques are being developed for use with LB and to thereby allow detection of several targeted therapeutics of interest with a single approach. However, these approaches probably still lack sufficient sensitivity to date and different ring studies will be probably useful before using them in clinical routine practice.