The 2024 International Association for the Study of Lung Cancer Global Survey on Biomarker Testing

Biomarker status is vital to inform optimal care for individuals with lung cancer, yet implementation of testing has been suboptimal due to cost, lack of quality and standards, access, awareness, and long turnaround times. Recent therapeutic advances in late- and early-stage lung cancers motivated a second global survey on comprehensive biomarker testing in 2024.

The International Association for the Study of Lung Cancer convened a global multidisciplinary committee to develop the survey. We used a mixed methods framework, with qualitative focus groups and in-depth interviews informing the primarily quantitative survey. The survey was available in six languages.

We received 1677 responses across 90 countries and 14 disciplines. Respondents believe that biomarker testing significantly affects outcomes (98.3%) and have a clear understanding of who should receive testing (91.2%). Nevertheless, only 63.4% and 29.4% ranked it highly important to perform comprehensive biomarker testing in late- and early-stage lung cancer, respectively. Many respondents (67%) estimated that more than half of individuals with lung cancer are biomarker tested in their country, up from 39% in the 2018 survey (p value < 0.0001). Nevertheless, 43% of the respondents sometimes or often treat patients before receiving biomarker results. The highest ranked barriers were cost (27.2%), time (13.9%), sample quality (13.8%), access (12.8%), and awareness (8.0%). We found that the health care system support for biomarker testing varied by country-level income.

We found improvements in the perception of testing rates compared with that in 2018, but continued and substantial barriers exist. Future initiatives will use these data to target awareness, access, processes, and policy initiatives to improve comprehensive testing globally.