Lung Cancer Biomarker Testing in North America: Matthew Smeltzer, PhD, Unpacks the Data

Matthew Smeltzer, PhD, of the University of Memphis School of Public Health, joined Lung Cancers Today at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting to discuss results from an analysis of the International Association for the Study of Lung Cancer (IASLC) Global Biomarker Testing Survey. This follows the initial presentation of the survey results at the IASLC 2024 World Conference on Lung Cancer.

This analysis compared results from North America with global results by high-income and low- or middle-income countries, with the survey showing that 99% of respondents in North American believe that biomarker testing significantly impacts outcomes for patients and 94% report that they have “a clear understanding of whom should be tested,” he said.

“That was good news. There seems to be a general consensus that we should be doing this,” he said.

When respondents were asked if they believed that at least half of the people in their country get tested, Dr. Smeltzer said there was an improvement compared with prior results.

“We asked this question in 2018 on the previous survey, and it was only 39% for the world,” he said. “We repeated that question in 2024, and it went up to 67% for the world, which was a statistically significant increase. In North America, it was 69%.”

Dr. Smeltzer pointed to other notable findings from the study, which included that 40% of respondents in North America indicate that treatment for lung cancer is often initiated before receipt of the results of biomarker testing. However, when broken down globally, the results revealed that 73% of respondents in low- to middle-income countries reported that lung cancer treatment is often initiated before receipt of the results of biomarker testing, indicating a major gap.

“We have seen improvements in the perception of testing,” he explained. “But we still have a big barrier for everyone to get this biomarker testing, which they need in order to ensure that they’re getting optimal therapy.”

Some potential solutions provided by respondents included implementing testing protocols, government-level interventions, addressing cost and reimbursement, general awareness and education, increasing administrative and organizational support, and expanding access and availability.

“The question is, “How can we provide the resources or help figure out how the resources can be provided?” Dr. Smeltzer said. “And then, if you have the resources, do you have the organizational support to do [biomarker testing] in an efficient way, get quick turnaround times, and really implement this well and in clinical practice?”