Foundations of Comprehensive Biomarker Testing in NSCLC

This opening segment introduces the program and establishes the central role of comprehensive biomarker testing in the modern management of non-small cell lung cancer (NSCLC). Dr. Wistuba and Dr. Santos outline the rapidly evolving landscape of biomarker-driven care, emphasizing the need for coordinated use of molecular and immunohistochemical testing to support personalized treatment decisions.

Dr. Santos highlights that current clinical practice is guided by major professional society recommendations, including those from NCCN, ASCO, and IASLC, which consistently support broad molecular profiling at diagnosis, particularly in advanced disease. Tissue-based next-generation sequencing remains the preferred approach because it enables deep genomic characterization from a single specimen, allowing assessment of multiple actionable alterations simultaneously. However, liquid biopsy is increasingly recognized as an important complementary tool, especially when tissue is limited or when rapid results are needed. Because circulating tumor DNA testing often returns results more quickly than tissue analysis, parallel testing with both modalities may help accelerate treatment selection for patients with metastatic disease.

The discussion also underscores the continued importance of immunohistochemistry (IHC) in the biomarker workflow. PD-L1 testing remains a cornerstone for guiding immunotherapy decisions, but the panel notes that additional protein-based biomarkers (such as HER2 and c-MET) are becoming increasingly relevant as new targeted and antibody-drug conjugate therapies emerge. NSCLC management is becoming increasingly dependent on timely, comprehensive, and multimodal biomarker assessment.