Biomarker testing looks for changes in a tumor's DNA that drive the cancer. In non-small cell lung cancer (NSCLC), those results can point to targeted therapies. At the time of this recording, panelists counted 11 actionable biomarkers in NSCLC, up from almost none a little over a decade ago.
Testing is still not universal. In this conversation, a lung cancer survivor, an academic thoracic oncologist, and a community oncologist talk about what gets in the way and what helps. The panel used North Carolina as a model, because it has world-class academic centers alongside rural and underserved communities with far less access.
Key takeaways
Testing gaps are real, and wider in underserved communities
One study cited in the session found that at least 4 in 10 patients in a national oncology practice network started treatment before biomarker testing. Another showed the gap is larger where people have less access to modern care.
Ask for your report, not just your results
Terri Conneran was tested at diagnosis, but she did not see her report. When she asked about her biomarkers, she was told she had none. After two recurrences, a second opinion showed she had KRAS G12D. It did not change her treatment, but it changed everything else: she could find people like her, learn about trials, and tune out misinformation. She went on to found KRAS Kickers, now in 110 countries.
Rural care brings extra barriers
The community oncologist described patients who arrive late and very sick, with too little time to wait two to four weeks for results. Fewer specialists can also mean only one chance at a biopsy, and sometimes not enough tissue to test.
Liquid biopsy can speed things up
Both oncologists now send a blood-based liquid biopsy alongside tissue. The academic oncologist said basic results can come back in about a week to 10 days, and that blood and tissue results line up more often at diagnosis than at recurrence, when more tissue is preferred.
When there is time, waiting for results can matter
The academic oncologist encouraged colleagues and patients who are not severely ill to wait the roughly two weeks for results, and pointed to research where starting treatment before results came back was linked to worse outcomes. When patients cannot wait, he described starting with chemotherapy alone until results arrive.
Cost is less of a barrier than many patients fear
Both doctors said broad testing panels are now widely approved, since private insurers tend to follow Medicare. Labs they work with often release results before insurance is settled and offer patient assistance programs. Financial strain, transportation, and daily needs remain real burdens for many patients.
Plain language and second opinions help
A study the panel discussed found about half of patients did not understand the word “mutation” after talking with their oncologist. The doctors tailor explanations, for example describing a “change in the DNA.” Terri reminded clinicians that patients often need permission to seek a second opinion.
In this video
- 0:00 Opening and why biomarkers matter in NSCLC
- 6:09 Meet the panel
- 8:38 Patients, biomarker testing, and care teams
- 19:50 Barriers and challenges
- 35:44 Community and connection
- 39:11 Insurance and lab testing
- 46:33 How oncologists keep up with changes
- 51:52 Feeling empowered to seek a second opinion
- 54:07 Final thoughts
Questions to bring to your care team
- Was my tumor tested for biomarkers, and with a broad panel?
- Can I have a copy of my biomarker report?
- Was a liquid biopsy done too?
- If cost is a worry, does the lab have a patient assistance program?
- Would a second opinion help in my situation?
Common questions about biomarker testing
What is biomarker testing for lung cancer?
It tests a tumor sample, or a blood sample, for genetic changes that drive the cancer. In non-small cell lung cancer, those results can point to targeted therapies matched to that change.
Can biomarker testing be done with a blood test?
Yes. A liquid biopsy looks for tumor DNA in the blood. Oncologists on the panel send it alongside a tissue biopsy because it can return basic results faster.
How long do biomarker results take?
The panel described about two to four weeks for full tissue results, and about a week to 10 days for basic liquid biopsy results.
Is biomarker testing covered by insurance?
The oncologists said broad panels are now widely covered, and that labs often have patient assistance programs. Ask your care team or the lab if cost is a concern.
Learn how Gryt Health puts lived experience to work in research and real-world evidence.
This page summarizes a recorded conversation and shares lived experience. It is not medical advice. Talk with your oncology team about your own care. The session was supported by EMD Serono, which did not promote any product during the program.