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Biomarker testing for non-small cell lung cancer

Get the essential facts about this important tool for the diagnosis and treatment of non-small cell lung cancer.

Updated on September 12, 2025

More than 200,000 Americans are diagnosed with lung cancer annually. Every case is different, and certain treatments work better for some than for others. To better tailor therapy to each individual, oncologists may use biomarker testing, a diagnostic tool sometimes called genetic, genomic, molecular or mutation testing.

Biomarkers are measurable molecules found in the body’s tissues or fluids. They can indicate disease, changes in your biological processes—or that your body is functioning just fine. For patients with certain types of lung cancer, biomarker testing helps healthcare providers make a diagnosis, predict outcomes and response to various treatments, and monitor the disease during treatment.

Biomarker testing is constantly evolving, with many studies currently in progress. Here’s what you need to know right now.

How biomarker testing works

There are two main kinds of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). It’s estimated that between 80 to 85 percent of patients have NSCLC, the more common type, while 10 to 15 percent have SCLC. Biomarker testing is most commonly performed on people with NSCLC.

People with NSCLC often undergo this testing to reveal whether they would benefit from two newer types of cancer treatment, targeted therapy or immunotherapy—and if so, which medicines would best suit them.

  • Immunotherapy uses drugs to help your immune system spot and wipe out cancer cells. Your levels of a protein called PD-L1 help determine if immunotherapy is right for you.
  • Targeted therapy attacks specific molecules that promote the growth of cancer cells. This is different than standard chemotherapy drugs, which target all rapidly dividing cells in the body, both normal and cancerous. Biomarker testing can identify gene mutations that may respond to targeted therapy. EGFR, ALK, ROS1 and BRAF are all examples of mutations.

When specific treatment is better matched to the individual patient’s specific cancer, health outcomes often improve.

The basics of biomarker testing

Patients may undergo biomarker testing at or after diagnosis, or if NSCLC has recurred. Speak with your healthcare provider about your options. If you decide to go ahead, reach out to your health insurance provider to confirm you’re covered—or ask a member of your cancer care team to call, like your case manager or social worker.

Here’s how testing is done: Your tumor will be biopsied or removed completely, and samples will be delivered to a lab for testing. Results should come back within two weeks, at which point an oncologist can interpret them and explain it to you. Blood or urine may also be tested for biomarkers—a technique called a “liquid biopsy.” This can help healthcare providers understand if a cancer has become resistant to a targeted therapy, and measure the response of a particular targeted therapy.

Those results will inform therapy recommendations moving forward—but they won’t be the only factors in your plan. Your general health, co-existing medical conditions, the type and stage of your cancer, and your treatment goals will also influence your healthcare provider’s strategy. Together, they can help you achieve the best possible health outcome.

Article sources open article sources

National Cancer Institute. Lung and Bronchus Cancer — Cancer Stat Facts. Accessed September 12, 2025.
American Lung Association. State of Lung Cancer 2024. September 2024.
American Lung Association. State of Lung Cancer 2023. October 2023.
LUNGevity Foundation. What You Need to Know About Biomarker Testing. November 2017.
National Cancer Institute. Definition of Biomarker. Accessed September 12, 2025.
American Lung Association. Glossary of Lung Cancer Terms. Accessed September 12, 2025.
Dana-Farber Cancer Institute. What Is a Biomarker. October 2018.
Naidoo, Jarushka. Biomarker Testing for Immunotherapy. May 2019.
CancerCare. The Role of Lung Cancer Advocacy Organizations in Biomarker Testing. August 29, 2018.
American Cancer Society. What Is Lung Cancer. January 29, 2024.
National Cancer Institute. Definition of Immunotherapy. Accessed September 12, 2025.
American Cancer Society. Immunotherapy for Non-Small Cell Lung Cancer. March 13, 2025.
American Lung Association. Immunotherapy for Lung Cancer. October 1, 2024.
National Cancer Institute. Targeted Cancer Therapies. May 31, 2022.
American Cancer Society. Targeted Therapy for Non-Small Cell Lung Cancer. August 13, 2025.
American Lung Association. Targeted Therapies for Lung Cancer. February 12, 2025.
American Cancer Society. Who Is the Cancer Care Team. August 13, 2025.
Lindeman NI, Cagle PT, et al. Molecular testing guideline for selection of lung cancer patients for EGFR and ALK tyrosine kinase inhibitors: guideline from the College of American Pathologists, International Association for the Study of Lung Cancer, and Association for Molecular Pathology. J Thorac Oncol. 2013 Jul;8(7):823-59.

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