Recent Trends in Biomarker Testing for NSCLC: Maximizing Real-World Survival
Comprehensive biomarker testing—including genes such as EGFR, ALK, ROS1, BRAF, KRAS, MET, RET, HER2 (ERBB2), NTRK1-3, and PD-L1—is critical for guiding personalized treatment strategies in NSCLC and is recommended by NCCN guidelines1.
Bronchoscopic approaches—particularly endobronchial ultrasound (EBUS)-guided biopsy—are preferred for tissue acquisition, offering safety and sufficiently high biomarker yields while being less invasive compared to traditional methods1.
Liquid biopsy (ctDNA testing) is increasingly used in advanced NSCLC cases for faster and less invasive biomarker analysis; however, tissue biopsy remains preferred, especially in early-stage disease, and is required for histologic diagnosis1.
The rates of biomarker testing in advanced NSCLC (aNSCLC) rose significantly between 2015 and 2018, plateauing at substantial uptake, with data showing patients who underwent testing had longer overall survival compared to untested counterparts24.
Not all patients have equal access to biomarker testing; disparities depend on clinical and demographic factors, which can affect survival outcomes and treatment options24.
Next-generation sequencing (NGS) is the main technology driving genomic aberration detection and is capable of identifying a wide range of actionable mutations, gene fusions, and copy number variations for NSCLC molecular profiling3.
Mutational profiling (e.g., for EGFR and ALK) directly determines the eligibility and utility of targeted therapies, underscoring biomarker testing as a cornerstone of precision oncology and survival optimization in real-world NSCLC management4.
Current research focuses on optimizing diagnostic workflows, improving tissue adequacy for tests, enhancing the speed of results, cost-effectiveness, and expanding actionable biomarker panels through technological advances13.
Sources:
1. https://www.targetedonc.com/view/biomarker-testing-in-nsclc-leads-to-renewed-focus-on-biopsy-outcomes
2. https://pubmed.ncbi.nlm.nih.gov/36656547/