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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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Evaluating Effective Biomarker Testing for Advanced Non-Small Cell Lung Cancer in US Community Oncology Practices.

Christian A Thomas1,2, Sibel Blau2,3, Heather Neuhalfen2

  • 1New England Cancer Specialists, Westbrook, ME.

JCO Oncology Practice
|April 22, 2026
PubMed
Summary

Biomarker testing for advanced non-small cell lung cancer (NSCLC) is crucial but often delayed. Effective testing rates, providing actionable results before treatment, were only 72% in a US community oncology setting.

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Area of Science:

  • Oncology
  • Molecular Diagnostics
  • Cancer Research

Background:

  • Biomarker testing is standard for advanced non-small cell lung cancer (NSCLC).
  • Identifying actionable mutations (e.g., EGFR, ALK, KRAS) guides treatment decisions.
  • Effective testing ensures results are available before therapy initiation.

Purpose of the Study:

  • To quantify effective biomarker testing rates in a contemporary US community oncology setting.
  • To identify patient factors associated with timely and comprehensive biomarker testing.
  • To assess the gap between overall testing and effective testing for advanced NSCLC.

Main Methods:

  • Retrospective analysis of 306 patients with stage IIIB/IV NSCLC from 30 US community oncology practices.
  • Data included demographics, disease characteristics, testing details (type, assays, dates), and result availability.
  • Focus on results available at diagnosis versus start of systemic therapy.

Main Results:

  • Overall biomarker testing rate was 93.1%, but effective testing was significantly lower at 72.0%.
  • Patients with adenocarcinoma and those receiving systemic therapy were more likely to undergo testing.
  • Only 39.5% of patients were tested for all 13 recommended biomarkers.

Conclusions:

  • High overall testing rates mask a critical gap in timely results for advanced NSCLC patients.
  • Over 20% of patients lack actionable results before treatment initiation, potentially limiting access to targeted therapies.
  • Streamlined diagnostic workflows and faster turnaround times are needed for optimal, evidence-based community oncology care.