{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T21:44:58Z","timestamp":1793137498075,"version":"4.5.0"},"reference-count":36,"publisher":"Harborside Press, LLC","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"\n Background:<\/jats:bold>\n Patients with advanced non\u2013small cell lung cancer (aNSCLC) are recommended to undergo molecular testing for targetable genomic alterations. However, as high-throughput methods are increasingly used, long test turnaround time (TAT) may lead to lower receipt of appropriate targeted therapy. Guidelines recommend a 2-week TAT for\n ALK<\/jats:italic>\n and\n EGFR<\/jats:italic>\n testing, 2 prevalent pathogenic alterations with highly effective targeted therapies.\n Patients and Methods:<\/jats:bold>\n Using an electronic health record\u2013derived, deidentified database, we conducted a retrospective cohort study of patients with aNSCLC diagnosed between 2011 and 2023 who received testing for \u22651 of 8 molecular markers. We assessed the number of biomarkers tested per patient, testing modality, and TAT (defined as the interval between specimen collection and result date) over time. We also evaluated patients with\n ALK<\/jats:italic>\n \/\n EGFR<\/jats:italic>\n -altered aNSCLC who initiated early nontargeted treatment prior to test result availability, examining associations with TAT and clinical outcomes.\n Results:<\/jats:bold>\n The study sample comprised 33,945 patients, with a mean age of 68.2 years; 49.4% were female, 58.3% were White, and 83.4% reported a history of smoking. From 2011 to 2023, the mean number of biomarkers tested per patient (range, 2.0\u20136.8) and the use of next-generation sequencing (NGS) increased, whereas the mean TAT converged to 3 weeks. Fewer than half of the patients with\n ALK<\/jats:italic>\n \/\n EGFR<\/jats:italic>\n -altered aNSCLC had a TAT of \u22642 weeks, and 1 in 8 initiated early nontargeted treatment. Longer TAT was associated with early nontargeted treatment when analyzed as both a continuous variable (odds ratio, 1.83 per week) and a binary variable (TAT >2 vs \u22642 weeks; odds ratio, 6.02). Early treatment was associated with worse median progression-free survival (9 vs 11 months) in patients with\n ALK<\/jats:italic>\n \/\n EGFR<\/jats:italic>\n -altered aNSCLC.\n Conclusions:<\/jats:bold>\n Biomarker testing and NGS use have increased over time in US patients with aNSCLC. TAT has plateaued and remains longer than recommended in consensus guidelines. Longer TAT was associated with early nontargeted therapy in patients with\n ALK+<\/jats:italic>\n \/\n EGFR<\/jats:italic>\n + aNSCLC, leading to suboptimal first-line treatment and poorer clinical outcomes.\n <\/jats:p>","DOI":"10.6004\/jnccn.2025.7063","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:40:41Z","timestamp":1760103641000},"page":"461-467","source":"Crossref","is-referenced-by-count":10,"title":["Molecular Biomarker Testing Patterns and Turnaround Time in US Patients With Advanced Non\u2013Small Cell Lung Cancer"],"prefix":"10.6004","volume":"23","author":[{"given":"Xiao","family":"Wang","sequence":"first","affiliation":[{"name":"Section of Medical Oncology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT"},{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do H.","family":"Lee","sequence":"additional","affiliation":[{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szu-Chun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT"},{"name":"Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela R.","family":"Soulos","sequence":"additional","affiliation":[{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cary P.","family":"Gross","sequence":"additional","affiliation":[{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center, New Haven, CT"},{"name":"Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT"},{"name":"Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center, New Haven, CT"},{"name":"Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne C.","family":"Chiang","sequence":"additional","affiliation":[{"name":"Section of Medical Oncology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","series-title":"J Natl Compr Canc Netw","first-page":"249","volume":"22","author":"Riely GJ","year":"2024","unstructured":"Riely GJ, Wood DE, Ettinger DS, Non-Small Cell Lung Cancer, Version 4.2024, NCCN Clinical Practice Guidelines in Oncology. 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