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Updated: Jul 17, 2025

Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
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Biomarker Testing, Treatment, and Outcomes in Patients With Advanced/Metastatic Non-Small Cell Lung Cancer Using a

Naleen Raj Bhandari1, Lisa M Hess1, Dan He2

  • 1Eli Lilly and Company, Indianapolis, Indiana.

Journal of the National Comprehensive Cancer Network : JNCCN
|September 6, 2023
PubMed
Summary
This summary is machine-generated.

Biomarker testing in advanced non-small cell lung cancer (a/mNSCLC) improves survival. Guideline-concordant therapy following biomarker testing is associated with better outcomes for patients with a/mNSCLC.

Keywords:
Biomarkersnon-small cell lung canceroverall survivalreal-world electronic medical record databasetargeted therapy

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Area of Science:

  • Oncology
  • Biomarker Discovery
  • Clinical Trials

Background:

  • Limited understanding of up-front biomarker testing's impact on long-term outcomes in advanced or metastatic non-small cell lung cancer (a/mNSCLC).
  • Real-world data is crucial for evaluating testing strategies and treatment concordance.

Purpose of the Study:

  • To compare overall survival (OS) based on biomarker testing status.
  • To assess the impact of guideline-concordant therapy on OS in a/mNSCLC patients.
  • To analyze real-world data for treatment decision-making in a/mNSCLC.

Main Methods:

  • Retrospective analysis of a large real-world a/mNSCLC electronic healthcare records database.
  • Inclusion of patients with nonsquamous a/mNSCLC initiating first-line therapy from January 1, 2015.
  • Kaplan-Meier analysis and multivariable Cox proportional hazard modeling to compare OS.

Main Results:

  • 88% of patients had at least one biomarker test recorded; 69% were tested before or at first-line treatment initiation.
  • Higher hazard of death observed in patients never tested (HR 1.30) or not tested before first-line therapy (HR 1.12).
  • Increased hazard of death (HR 1.25) for patients with biomarker-positive disease not receiving guideline-concordant first-line treatment.

Conclusions:

  • Up-front biomarker testing is associated with improved survival in a/mNSCLC.
  • Guideline-concordant first-line therapy following biomarker testing significantly improves survival outcomes.
  • Real-world evidence supports the integration of biomarker testing into treatment decisions for a/mNSCLC.