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Updated: Apr 24, 2026

Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
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Biomarker Testing Rates and Patterns in Patients With Metastatic Non-Small Cell Lung Cancer: A Prospective,

Makenzi Evangelist1, Bo Wang2,3, James E Butrynski2,3

  • 1New York Oncology Hematology, Albany, NY.

JCO Precision Oncology
|April 22, 2026
PubMed
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This summary is machine-generated.

Biomarker testing in metastatic non-small cell lung cancer (mNSCLC) improved, with nearly 80% of patients with actionable alterations receiving targeted therapy, leading to favorable survival outcomes.

Area of Science:

  • Oncology
  • Genomics
  • Clinical Trials

Background:

  • Targeted therapies improve outcomes for non-small cell lung cancer (NSCLC) patients with genetic alterations.
  • Biomarker testing is crucial for identifying actionable alterations (AAs) to guide treatment decisions.

Purpose of the Study:

  • To evaluate biomarker testing rates and outcomes in patients with metastatic non-small cell lung cancer (mNSCLC).
  • To compare current testing practices with previous retrospective data.

Main Methods:

  • Prospective, noninterventional, observational study of 556 mNSCLC patients across 18 US community practices (2020-2022).
  • Examined biomarker testing rates, modalities (including next-generation sequencing [NGS]), timing relative to first-line (1L) therapy, AAs, 1L therapies, and survival outcomes.

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  • Compared findings with a prior retrospective analysis (Protocol 1).

    • Main Results:

    • 98.8% of patients received biomarker testing, with 79.0% receiving results before 1L therapy (an improvement from Protocol 1).
    • Next-generation sequencing (NGS) testing and results before 1L therapy increased significantly compared to Protocol 1 (55.6% vs 5.0%).
    • Among 94 patients with AAs who received test results before 1L therapy, 77.7% received 1L targeted therapy, with trending favorable survival outcomes.

    Conclusions:

    • Biomarker testing rates, including guideline-compliant (8-gene) and NGS, show improvement but still fall short of recommended guidelines.
    • Nearly 80% of patients with actionable alterations who received test results before 1L therapy were treated with targeted therapy.
    • Effective follow-through from biomarker testing to targeted treatment is critical for improving survival in mNSCLC patients.