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Biomarker testing helps doctors understand a person’s unique type of lung cancer. For people diagnosed with lung cancer, these tests can identify certain gene changes or protein levels that guide care for newly diagnosed patients.
Timing matters. When biomarker test results are available before initial treatment decisions are made, patients and clinicians can consider the full gamut of treatment options and make an optimized plan. When results are delayed, the treatment plan may be decided before all biomarker information is available. This could lead to patients being placed on a sub-optimal treatment that is not designed for their type of lung cancer.
To ensure that patients get the best possible care, LUNGevity teamed up with the Association for Molecular Pathology and the American Society for Clinical Pathology to conduct a national survey to determine how widely standardized protocol-driven biomarker testing is used in non–small cell lung cancer (NSCLC) and which barriers play a role in delaying testing and test results. This type of testing, where biomarkers are ordered as close to the biopsy as possible, is sometimes called “reflex testing.”
Definition of Reflex Testing
Reflex testing means biomarker testing is automatically initiated according to a standardized protocol after diagnosis or specific pathology findings, rather than waiting for a separate order later, for example after the patient visits the oncologist.
You can learn more about this paper by:
- Watching the video below from lead author Lynnette Pineault, MBA, Manager of Anatomic Pathology and Genetic Counseling Services for HealthPartners in Minnesota and an ASCP consultant on this important work.
- Downloading a one-pager with key highlights of this study.
- Digging into details below.
What did the study explore?
The study surveyed 111 healthcare professionals involved in non-small cell lung cancer biomarker testing in the United States. Researchers asked about institutional standardized protocols for comprehensive biomarker testing, use of reflex testing for broad multi-gene panels, ordering practices, availability of results by the first patient-oncologist consult, and barriers to pathologist-ordered biomarker testing.
Key findings
1. Only one-third of respondents reported that comprehensive biomarker results were available before the oncology visit to select first-line treatment, highlighting a critical gap in the patient care pathway.
2. Standardized protocols were commonly reported. More than three-quarters of respondents said their institution had a standardized protocol for comprehensive biomarker testing. Most of these protocols included reflex testing with a broad multi-gene panel.
3. Operational barriers may slow results. Respondents noted barriers such as reimbursement issues, insurance authorization delays, workflow constraints, and Medicare policy rules.
Why this matters
For patients and care partners, a helpful question to ask is whether comprehensive biomarker testing has been ordered and when results are expected. For health systems, these research findings suggest that protocols, coordination, and reimbursement processes may all affect whether biomarker results are ready before treatment decisions are made.
Read the full research paper here: Standardized protocols for reflexing to a multigene panel for patients with non–small cell lung cancer: prevalence and perceived barriers to comprehensive, pathologist-ordered biomarker reflex testing