Molecular testing may be underused in patients with metastatic non-small cell lung cancer (NSCLC), according to a study published in Clinical Lung Cancer.

Roughly half of patients in the study underwent molecular testing, and testing was associated with shorter time to systemic treatment.

The study included 3600 patients from 8 healthcare systems (mostly academic centers) who were diagnosed with metastatic NSCLC between 2011 and 2018. The patients’ median age at diagnosis was 64 years, 54.3% of patients were men, 81.6% were non-Hispanic White, and 54.1% had more than 2 comorbidities. 

Continue Reading

Molecular testing was conducted in 49.9% of patients (n=1797), and 74.5% of these patients underwent more than 1 type of test. Testing for EGFR (39%), KRAS (17.5%), and BRAF (14.5%) mutations was common.

Patients with 2 or more comorbidities were significantly more likely to undergo molecular testing (adjusted risk ratio, 1.21; 95% CI, 1.05-1.40; P =.01) and had a shorter time to testing than patients with 0 to 1 comorbidities (adjusted hazard ratio [aHR], 1.4; 95% CI, 1.03-1.9; P =.03).

Overall, 56.8% of patients (n=2045) received initial systemic treatment within 90 days of diagnosis. Earlier initiation of systemic treatment was significantly associated with receipt of molecular testing (aHR, 1.59; 95% CI, 1.24-2.04; P <.001).

“Receipt of molecular testing in academic centers was associated with earlier initiation of systemic treatment,” the researchers wrote. “This finding underscores the need to increase molecular testing rates amongst mNSCLC patients during a clinically relevant period. Further studies to validate these findings in community centers are warranted.”


Osazuwa-Peters OL, Wilson LE, Check DK, et al. Factors associated with receipt of molecular testing and its impact on time to initial systemic therapy in metastatic non-small cell lung cancer. Clin Lung Cancer. Published online March 18, 2023. doi:10.1016/j.cllc.2023.03.001