• Roughly 30% of patients with biomarker-positive disease did not receive the indicated 1L guideline-recommended targeted therapy despite availability of NGS test results prior to 1L initiation • Patients treated with 1L targeted therapy had the longest median overall survival • EHR-based alerts could help increase the uptake of biomarker-driven treatment • There is an unmet need for 1L treatment in a/mNSCLC, particularly for KRAS G12C B-NGS, 1348) patients were eligible. The median age was 71 years, 52% female, 62% White, and 83% smokers. Approximately 32% (T-NGS, 35%; B-NGS, 32%) of patients were positive for biomarkers and receipt of targeted therapy (TT) in 1L was ≤68% (T-NGS, 67%; B-NGS, 70%). Median OS was longest for ‘TT → none’ in the biomarker-positive subgroups of both cohorts. Approximately 30% of patients with biomarker-positive disease did not receive the indicated 1L guideline-recommended TT despite availability of NGS test results prior to 1L initiation. These findings highlight variability in 1L treatment selection for patients with biomarker-positive a/mNSCLC and underscore the need for further research to understand barriers to TT use. Health systems should consider proactive, scalable solutions (e.g., EHR-based alerts) to ensure that biomarker-driven treatment is not just possible but reliably delivered.
Marmarelis et al. (2026) studied this question.