People with advanced lung cancer lived about two months longer when their tumor got a broad gene test before treatment, study finds

People with advanced lung cancer lived about two months longer, on average, when doctors tested their tumor for many gene changes at once before starting treatment, instead of testing for just one or two, according to a study in the November issue of JNCCN, the journal of the National Comprehensive Cancer Network.  The network is an alliance of leading U.S. cancer centers that writes widely used treatment guidelines.

The lead author, Dr. Patricia Mae G. Santos of Emory University, gave patients and families one question to ask their care team before treatment starts:  “Has my tumor had comprehensive biomarker testing?”

Why the test matters

Many lung tumors are driven by a specific change in a gene, such as EGFR or ALK.  Some newer drugs, called targeted therapies, attack tumors with a particular change and can work better and be easier to tolerate than older treatments, the network said.  The FDA has approved 22 targeted therapies for advanced non-small cell lung cancer, the most common type, since 2011, the study says.

Broad-based genomic sequencing checks a tumor sample for changes in dozens or hundreds of genes at once; the study counted any panel of 30 or more genes.  Focused testing looks only for one or two common changes.  The network’s guidelines already recommend broad testing for advanced lung cancer.

In California, state law has since 2022 barred state-regulated health plans, including Medi-Cal managed care plans, from requiring prior authorization, or advance approval, for biomarker testing in people with stage 3 or 4 cancer when the test is tied to an FDA-approved treatment.

What the study found, and what it can’t prove

Among patients matched to be alike in age, health, insurance and other traits, those who got broad testing before their first treatment lived a median of 16 months, compared with 14 months for focused testing.  The time before the cancer grew again was also slightly longer, 6.4 months versus 6.0 months.  Broad testing found a target gene change in 60% of patients, compared with 22%, and 19% got a targeted drug, compared with 16%.

Testing done later, just before a second round of treatment, was not linked to longer survival, which the authors say points to testing early.

The researchers looked back at electronic health records for 35,060 adults treated from 2016 to 2022 at about 280 U.S. cancer clinics, using the Flatiron Health Research Database, a large collection of cancer-patient records.  Because patients were not randomly assigned to a test, the study shows a link, not proof that the test caused the longer survival.  Patients who got broad testing were more often privately insured and were mostly diagnosed in later years, when more drugs existed; the researchers used statistical matching to try to account for such differences.

Source:  National Comprehensive Cancer Network news release, Nov. 12, 2026; *JNCCN* study, Santos et al.; California Health and Safety Code section 1367.665.