Gerhad Mostbeck, MD of the Otto Wagner Hospital, Vienna, Austria talks about the challenges associated with biopsies for the diagnosis of lung cancer. The decision to go forward with a biopsy procedure is taken within an interdisciplinary team of doctors and takes into consideration the invasiveness of the procedure and associated risks as well as the accuracy of the methods used and importantly, patient’s consent. Another challenge is that lung cancer changes throughout the course of the disease; it changes with treatment and with metastasis. This means that medical teams have to conduct more biopsies than they were used to before the era of targeted therapies in order to ensure that patients can receive specific personalized treatment. Recorded at the 2016 World Conference of Lung Cancer (WCLC) of the International Association for the Study of Lung Cancer (IASLC) in Vienna, Austria.