Key takeaways

• Approximately one-third of survey respondents reported that non-small cell lung cancer (NSCLC) biomarker results were unavailable before initial treatment decisions.
• Focus group participants identified clearly defined responsibilities, automatic testing triggers, and role-based accountability as facilitators of timely biomarker testing.
• Oncology advanced practice providers (APPs) can support testing by coordinating specialties, tracking progress, and identifying workflow barriers.

Improving NSCLC biomarker testing requires more than standardized protocols, with oncology APPs positioned to support timely results through care coordination and communication, according to an abstract presented at the 2026 JADPRO Live meeting in Minneapolis, Minnesota.

The project combined findings from a published national survey with multidisciplinary focus groups. LUNGevity Foundation, the American Society for Clinical Pathology, and the Association for Molecular Pathology surveyed 111 health care professionals involved in NSCLC biomarker testing. Overall, 77.5% reported using an institutional standardized protocol, and 88.4% of those protocols incorporated multigene panel testing. However, approximately one-third reported that biomarker results were unavailable before initial treatment decisions.

Focus groups included self-selected survey participants representing physician assistants, nurse practitioners, oncology nurse navigators, pathologists, and administrators across academic, community, and private practice settings. Discussions explored workflow design, testing barriers, multidisciplinary roles, and strategies for improving testing processes.

Participants emphasized that successful implementation depended on clearly assigned institutional responsibilities, automatic testing triggers, and accountability tied to specific roles. They identified APP contributions in facilitating collaboration, monitoring testing progress, identifying barriers, and promoting completion of diagnostic processes.  Although participants supported pathologist-initiated testing as an approach to improve efficiency, some expressed discomfort assuming responsibilities traditionally held by oncologists, particularly when staging or treatment intent remained uncertain.

Additional barriers included fragmented communication, manual ordering, unclear ownership of testing decisions, limited institutional resources, and reimbursement challenges related to the Centers for Medicare & Medicaid Services 14-day rule. Participants called for consistent reimbursement policies supporting testing at biopsy or diagnosis, alongside professional society guidance to promote standardized workflows across care settings.

For oncology APPs, the findings highlight opportunities to improve communication and help ensure testing pathways are completed so biomarker results can guide treatment decisions. These findings describe survey and focus group perspectives on implementation, rather than measured improvements from an APP-led testing intervention.

Source

Griffith KM, Pineault L, Martin N, Kelly M, Temple Smolkin RL, Brown A. The role of advanced practitioners in timely biomarker testing in non-small cell lung cancer (NSCLC). Poster presented at: 2026 JADPRO Live; 2026; Minneapolis, MN. Poster JL1406P.