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Research highlights improved lung cancer biomarker testing in North America, though delays, costs, and limited satisfaction persist despite clinician awareness.

North American respondents to the 2024 International Association for the Study of Lung Cancer (IASLC) global survey said they understood the value of biomarker testing for lung cancer as well as who should be tested, according to a poster presentation at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.

“Testing practices have reportedly improved since 2018, yet less than half of NA [North American] respondents are satisfied with biomarker testing practices, and many patients are still treated without biomarker information,” wrote Matthew Smeltzer, PhD, and coauthors of the abstract.

The 2024 global survey was the association’s second to gauge the state of biomarker testing of lung cancer worldwide and barriers to implementation. The poster abstract reported results from North American respondents compared with those from other high-income countries.

Of the 1,677 global responses, 1,501 were from high-income countries, and 337 were from North America (including 287 from the US and 50 from Canada).

According to the abstract, 99% of North American respondents said they believe biomarker testing of lung cancer significantly impacts outcomes, and 94% (vs 91% in other high-income countries) reported a clear understanding of who should be tested. Sixty-six percent ranked biomarker testing as highly important in late-stage lung cancer, and 40% as highly important in early-stage lung cancer (vs a respective 64% and 28% in other high-income countries).

However, just 45% of respondents from North America were satisfied with biomarker testing conditions (vs 52% in other high-income countries). Some 69% estimated at least half of patients with lung cancer receive biomarker testing (vs 71% in other high-income countries), up from 45% in 2018. Yet 40% sometimes or often began treatment before obtaining biomarker results, the researchers reported.

Cost (23%), time (22%), and sample quality (20%) were key barriers to lung cancer biomarker testing in North America, consistent with trends across other high-income countries and globally, researchers reported.

Low- and middle-income countries reported worse conditions, with 73% sometimes or often beginning treatment before biomarker results and 48% confident or extremely confident in the adequacy of testing at their institution.

Research funding was provided by the IASLC, via the IASLC Partners for Thoracic Cancer Care.