Alan B. Sandler, MD, Corey J. Langer, MD, Anne S. Tsao, MD, David Gandara, MD, and Mark A. Socinski, MD, discuss access to molecular testing in advanced non-small cell lung cancer.

Sandler says that he admittedly could only guess that between 40% and 50% of newly diagnosed patients with NSCLC have molecular testing done at some point. Langer notes that if patients live long enough, those who undergo molecular testing become a majority but initially make up about a third of all NSCLC patients.

Tsao says that while the goal is for all patients to be tested, she estimates that only 20-25% of patients actually are tested. Gandara interjects that the majority of his patients with ALK fusion are former smokers but that testing should not be ruled out because of a smoking history.

Socinski says that community hospitals and academic centers often run into problems with regards to who orders testing. In academic centers, this problem does not exist as all samples are reflexively tested. In addition to getting an adequate sample and an oncologist and pathologist to do the testing, reimbursement also presents another hurdle at the community level.