Biomarker Testing, the Test-Know-Treat Framework, and Treatment Adherence in Late-Stage Metastatic EGFR-Positive NSCLC

Elizabeth Dennis describes the testing process following a new lung cancer diagnosis. Initial tissue biopsy is sent for next-generation sequencing (NGS), although repeat tissue sampling or liquid biopsy from blood may be needed if the initial biopsy is insufficient for molecular profiling. The waiting period for NGS results is a significant source of anxiety for patients, and education is the primary tool for managing this.

The test-know-treat framework provides a practical structure for explaining this wait to patients: test the tumor to understand its unique genetic makeup, know the results before initiating therapy, and then treat based on those specific findings to ensure the most appropriate and effective treatment is selected. This explanation helps patients understand that the delay is purposeful and directly serves their outcome.

Lynn Abbott-McCloud confirms that anxiety begins from the moment a cancer diagnosis is mentioned and intensifies through biomarker testing. LiveLung emphasizes mental health resources and the services available within cancer centers throughout this period. Dr. Konduri adds that while waiting for NGS results is the norm, rare circumstances, such as patients in significant physical distress from tumor burden, may require initiation of systemic therapy such as chemotherapy before molecular results are available.

On the importance of staying on treatment, Elizabeth Dennis notes that side effects during therapy do not indicate treatment failure. Managing side effects is a shared responsibility between the patient and the care team, with the goal of maintaining the therapeutic benefit of treatment for as long as possible.