Expanding Access to Biomarker Testing in Early-Stage NSCLC

Health care systems are implementing innovative approaches to expedite biomarker testing for patients with early-stage lung cancer, including surgeon-led ultrasound-guided biopsy practices that can reduce diagnostic timelines by approximately 3 weeks. This approach proves particularly valuable for patients traveling long distances for care, allowing comprehensive evaluation in a single visit rather than multiple appointments. Thoracic surgeons using point-of-care ultrasound can successfully obtain adequate tissue for comprehensive molecular testing in over 95% of patients, demonstrating the feasibility of this streamlined approach.

Despite these advances, significant barriers persist in delivering guideline-concordant biomarker testing to patients with lung cancer. Studies reveal that approximately one-third of eligible patients, even those with stage IV disease, do not receive appropriate molecular testing. The problem appears most pronounced outside academic medical centers, where general oncologists managing multiple cancer types may not be current with evolving lung cancer testing standards. Educational initiatives must extend beyond specialized centers to ensure all patients receive appropriate molecular characterization.

Liquid biopsy testing, while convenient, demonstrates insufficient sensitivity for early-stage disease and should not replace tissue-based molecular profiling. Patients and their families should understand that adequate tissue sampling remains the gold standard for comprehensive biomarker assessment in early-stage lung cancer. Health care providers must prioritize tissue-based testing to ensure patients receive accurate molecular characterization that will guide their entire treatment journey, from initial therapy selection through potential future treatment needs.