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Lung cancer treatment isn’t one-size-fits-all anymore. Doctors can now test lung cancer cells for biomarkers, which are specific changes in a tumor’s genes or proteins. Knowing which biomarkers are present in your lung cancer helps your care team choose treatments that are more likely to work well and cause fewer side effects.
These tests are part of a personalized medicine approach. The goal is to target cancer as precisely as possible. Instead of using treatments that affect the whole body, doctors can focus on therapies that interfere directly with the growth signals in cancer cells.
Genes in our DNA give instructions to make proteins. When a gene changes (mutates), it can cause the cell to make a protein that doesn’t work properly — or doesn’t work at all.
Every tumor is different, and treatments won’t work the same for everyone. However, identifying these genetic mutations and their proteins can help doctors better treat cancer. The U.S. Food and Drug Administration (FDA) has approved several targeted therapies, treatments that block specific mutated proteins linked to lung cancer.
Testing for these biomarkers is now a routine part of care for non-small cell lung cancer (NSCLC). The list of available tests and therapies continues to grow. Some hospitals offer multi-gene (comprehensive) testing panels that check for dozens of markers at once, making the process more efficient.
Learning about biomarkers can help you talk more confidently with your doctor, understand your treatment options, and stay informed about the future of lung cancer care.
Here are 12 key facts to know to help you better understand lung cancer biomarkers.
Biomarkers help doctors choose treatments that match your tumor’s specific features. Without this information, doctors may need to use broader treatments like chemotherapy, which can affect healthy cells too. That’s why biomarker testing plays such a key role in personalized lung cancer care.
To test for biomarkers, doctors usually collect tumor tissue with a biopsy or check for tumor DNA with a blood test, also called a liquid biopsy. It’s important to collect enough tissue or DNA so doctors can check for all the key biomarkers. If there’s not enough material, some important biomarkers may be missed.
Sometimes, doctors may recommend both a tissue biopsy and a liquid biopsy. Using both can give a more complete picture of your lung cancer.
After a tissue or blood sample is collected, it’s tested in a lab using techniques like DNA sequencing or protein analysis. One common test is called immunohistochemistry (IHC), which helps detect certain biomarkers in the tissue.
In an IHC test, antibodies that are attached to special dyes are put onto a tissue sample. The antibodies will only bind to the biomarker protein that is being tested for. When they bind to the protein, the dye is activated and can be seen under a microscope.
Changes in the epidermal growth factor receptor (EGFR) gene are a type of biomarker found in about 10 percent to 15 percent of NSCLC tumors. These mutations help cancer cells grow and divide.
Several FDA-approved treatments are available for NSCLC tumors with EGFR mutations, including:
There are several types of EGFR mutations, and some treatments target only specific ones. In some cases, researchers have found that combining medications can be more effective for treating EGFR-positive lung cancer.
In March 2024, the FDA approved amivantamab-vmjw (Rybrevant) with chemotherapy (carboplatin and pemetrexed) for locally advanced or metastatic NSCLC (cancer that has spread to other parts of the body) with EGFR exon 20 insertion mutations. A second approval followed for amivantamab-vmjw combined with lazertinib (Lazcluze) to treat locally advanced or metastatic NSCLC with EGFR exon 19 deletions or exon 21 L858R mutations.
These new treatment options offer hope for people whose cancer hasn’t responded to earlier EGFR therapies.
Read more about EGFR-positive lung cancer.
Some lung cancers are driven by gene fusions — mutations where parts of two genes fuse (join) together. This can lead to abnormal proteins that cause cancer to grow. The good news is that several FDA-approved treatments now target these fusion-related biomarkers.
Targeted therapies based on specific gene fusions include:
Some drugs appear in more than one category because they can target multiple gene fusions. Testing for these biomarkers early may help your care team start the most effective treatment as soon as possible.
The FDA has also approved treatments for lung cancer with MET biomarkers. Some changes to the MET gene result in a protein that encourages cancer cells to grow.
Targeted treatments are available for people with specific MET biomarkers, such as exon 14 skipping mutations or MET overexpression. These treatments include:
KRAS G12C is a biomarker seen in about 13 percent of advanced non-small cell lung cancers. Two drugs are now approved for these mutations:
These drugs target a mutation that was once considered “undruggable,” making this a major breakthrough in lung cancer treatment.
HER2 mutations are changes in a gene that can help cancer grow. While HER2 is often linked to breast cancer, these mutations can also occur in cancers of the ovaries, bladder, stomach, pancreas — and in NSCLC.
Fam-trastuzumab deruxtecan-nxki (Enhertu) was the first FDA-approved targeted therapy for HER2-mutant NSCLC. This gives people with HER2 changes treatment options beyond standard chemotherapy.
In June 2025, the FDA approved datopotamab deruxtecan-dlnk (Datroway) for EGFR-mutant NSCLC that no longer responds to prior treatments. This drug targets the TROP2 protein and delivers chemotherapy directly to cancer cells. This gives people who’ve run out of options a new path forward for hard-to-treat cancers.
PD-L1 is a protein on tumor or immune cells. Biomarker testing via IHC helps decide if immunotherapy is likely to work. Drugs used include:
A higher PD-L1 level often means a greater chance that immunotherapy will shrink or control the cancer.
Early research shows artificial intelligence (AI) models can analyze images or blood data to predict biomarker status, such as EGFR, ALK, or PD-L1, with an accuracy of around 77 percent to 79 percent. These tools may one day help guide care in places where sequencing labs aren’t available, though they aren’t yet standard. This technology could one day reduce the need for repeat biopsies and speed up diagnosis.
New biomarkers under study include:
Many of these targets are being tested in clinical trials right now. These discoveries could expand treatment options in the next few years.
Increasingly, biomarker-driven care is transforming lung cancer treatment. If your tumor has one of these gene changes or proteins, a targeted therapy or immunotherapy might offer better results with fewer side effects. Biomarker testing is essential to accessing current treatments and qualifying for clinical trials exploring future options.
Stay in close contact with your care team to explore both standard therapies and clinical trials as more are approved.
On MyLungCancerTeam, people share their experiences with lung cancer, get advice, and find support from others who understand.
Did your doctor discuss biomarkers with you? How have the results shaped your treatment plan for lung cancer? Share with others in the comments below.
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