The LUNGevity Foundation is marking Lung Cancer Awareness Month with a new year-long social media campaign to support its ongoing work to increase biomarker testing awareness. The #KnowYourBiomarker campaign encourages people with non-small cell lung cancer (NSCLC) to share their stories of biomarker testing. You can use the hashtag #KnowYourBiomarker on any social media platform to share your experience of how biomarker testing has affected your life.

The #KnowYourBiomarker social media campaign is part of the larger No One Missed campaign, which helps connect people diagnosed with non-small cell lung cancer with the information they need to ensure they receive comprehensive biomarker testing. The campaign site includes educational materials as well as a guide for talking with your oncologist about biomarker testing.

Biomarker testing for NSCLC is used to identify the genetic drivers of an individual’s cancer. Newer targeted therapies and immunotherapies for lung cancer are designed to work for people with a specific biomarker that affects how their cancer grows or interacts with the immune system. MyLungCancerTeam spoke with Dr. Amy Moore, vice president of global engagement and patient partnerships at LUNGevity Foundation, to learn more about the importance of biomarker testing.

Importance of Biomarker Testing

“We've made incredible advances in our understanding of lung cancer and non-small cell lung cancer in particular. Overall lung cancer deaths are declining. And that's largely attributable to new things like immunotherapy, as well as targeted therapies,” Moore told MyLungCancerTeam.

Based on the results of biomarker testing, oncologists can determine which treatment options have the best chance of treating someone’s lung cancer and which treatments may not be appropriate. Biomarker testing can also reveal if someone is a good candidate for a clinical trial of a treatment for their specific biomarker.

“Biomarker testing is really essential for making sure [people with NSCLC] get the best treatment to give them optimal outcomes,” Moore said.

Barriers to Biomarker Testing

While biomarker testing can help match people with the treatments that could extend their lives, not everyone receives this testing, for many different reasons.

Tissue Samples

Some barriers to testing are logistical, Moore explained. “Sometimes we don’t get enough tissue in order to do all the appropriate testing. When we talk about biomarker testing, we’re talking about testing tissue that’s derived from a biopsy. That’s one of the biggest barriers.”

Turnaround Time

Moore explained that biomarker testing should occur when someone is diagnosed with NSCLC, but the turnaround time for evaluating the tissue sample can be a barrier. “We’re all working to improve the timeliness of those testing results and then interpreting them and coming up with an action plan for a patient’s treatment. But sometimes that can take several weeks,” she explained.

This longer turnaround time can sometimes lead doctors and people with NSCLC to want to move forward without these results. “Depending on the acuity of a patient’s illness, there may be an urgency on the part of the patient, their family, or even a doctor may feel pressured to start them on some kind of therapy,” Moore said.

Depending on a person’s biomarker testing results, certain treatments may not be beneficial, Moore explained. “There is good reason to wait” for the results of the biomarker testing, Moore said, “but you certainly can understand the concerns both on the patient and caregiver side — as well as the provider — to want to act swiftly, especially when staring down a stage 4 lung cancer diagnosis. There’s that fear of waiting too long.”

Access

Another barrier to biomarker testing is access. In September, the International Association for the Study of Lung Cancer released results from a survey showing clinicians in academic medical settings used biomarker testing to inform treatment decisions more than their counterparts in community hospital settings — 73 percent compared to 48 percent.

In addition to the differences between community and academic medical settings, Moore noted that there are racial disparities in biomarker testing. A study released in May found disparities in biomarker testing in white and Black people diagnosed with lung cancer. The study found a 10 percentage-point difference between a type of biomarker testing in white versus Black individuals with NSCLC.

Cost

Moore noted that cost can also be a barrier to biomarker testing and treatment with targeted therapies and immunotherapies. A 2020 report from LUNGevity and the American Cancer Society Cancer Action Network found that private insurance coverage for biomarker testing has improved since 2018 but that gaps still remain, particularly around emerging biomarkers.

LUNGevity provides financial navigation support to help people with lung cancer manage the cost of care. “We don’t want costs to deter anyone from getting access to this potentially life-saving, life-extending, life-improving treatment,” Moore said.

Increasing Access to Biomarker Testing

The No One Missed Campaign is focused on addressing the obstacles that stand between people with lung cancer and biomarker testing.

Educating people with lung cancer is a key component of expanding access to biomarker testing. “We want to give patients something that’s very tangible that they can have in hand when they go to their own doctor’s appointment,” Moore explained. This includes a list of questions to ask an oncologist. “They need to feel confident going into those doctors’ appointments. They know what to ask.”

The current focus of No One Missed is people with lung cancer, but Moore explained that LUNGevity is also working to educate health care providers. “We recognize the disparity [in biomarker testing] is also driven by the providers themselves,” Moore commented. “So there’s an opportunity, particularly in community-based hospitals … to intervene and increase their awareness and knowledge of the utility of comprehensive biomarker testing.”

“We don’t want the burden to be uniformly on the patient,” she added.

LUNGevity prioritizes health equity as part of educating individuals with lung cancer and providers about biomarker testing. The organization has a Health Equity Council that works to address racial, socioeconomic, and geographic disparities that impact lung cancer care.