Biomarker testing: unlocking the unknown about lung cancer

“My husband was diagnosed with Stage IV lung cancer at the age of 43. My husband never smoked and it hit us like the world fell down on us” recalls Shani Shilo, Founder and CEO, Israeli Lung Cancer Foundation. Shani is not alone – a lung cancer diagnosis is devastating and leaves patients and their loved ones thinking, ‘what next?’

For Shani’s husband, the next step was to test the cancer for characteristics called biomarkers.

Lung cancer is more than one disease. It is made up of several different subtypes defined by different characteristics. Biomarker testing supports doctors in gaining a better understanding of the specific characteristics of a tumour. Most people with non-small cell lung cancer (NSCLC) have biomarkers that can be identified through testing.1-4

Based on the results of biomarker testing your doctor can make informed treatment decisions. This is crucial as patients with lung cancer face a risk of the cancer coming back even after surgery.4-7

Mark Brooke, CEO of Lung Foundation Australia, cared for his mother who passed away from lung cancer. His experience ignited a dedication to supporting others on their journey. Listen to Mark’s story and his perspective on the potential that biomarker testing holds for people with lung cancer.

Biomarkers are characteristics from cells that can be detected in tissue or in body fluids such as blood. Cancer biomarkers can include alterations to genes, proteins or changes to the immune system and they provide very relevant information about the subtype of the disease.2,4

The term ‘biomarker testing’ is used to describe the process of taking and testing a tumour sample to confirm if certain biomarkers are present. It is mainly conducted using a tissue sample, but sometimes a blood sample is used. Biomarker testing is also sometimes called tumour, genetic, genomic or molecular testing.2,4

  • Tissue sample: A small piece of tissue is taken through a biopsy or from the tumour tissue that has been removed during surgery 3

  • Blood sample: Some eligible patients may have a liquid biopsy - a small amount of their blood is tested to look for cancer cells or circulating biomarkers 3

Talk to your doctor about the possible risks of testing.

People with NSCLC are recommended to talk to their doctor about biomarker testing to identify the subtype of the disease before starting therapy - this is relevant at the time of diagnosis and also when there is recurrence or progression.6,7

Some patients are diagnosed with early-stage lung cancer, where the tumour can be removed through surgery. For other patients, the cancer has already progressed to an advanced stage and the tumour can no longer be removed by surgery.2 Biomarker testing is relevant for all patients with NSCLC, regardless of the stage of disease.6 Knowing whether your cancer does or doesn’t have biomarkers can help doctors develop a personalised treatment plan.3

Biomarker testing guidelines and availability can vary between countries and institutions, so it is important to discuss your options with your doctor.

​To help prepare for your doctor’s visit, this checklist of questions can help you learn more about biomarkers and testing.

Discover how knowing your cancer’s biomarkers can help inform your treatment decisions.

Working together towards a shared vision

At Roche, we are working closely with our partners – from patients and healthcare professionals to health systems and industry – towards our goal of improving the patient experience for every person, at every stage of their journey.

"We are on the cusp of delivering personalised care to far more people with cancer. But to do that, we have to immediately tackle the challenge of getting everyone tested for the underlying drivers of their disease so we have a better understanding of which treatments are right for which patients." – Charlie Fuchs, MD, MPH, Global Head of Oncology & Hematology Drug Development at Genentech and Roche.

Together we can redefine lung cancer


  1. Pakkala S. and Ramalingam S.S. Personalized therapy for lung cancer: striking a moving target. JCI insight. 2018;3(15). 

  2. Information about Non-Small Cell Lung Cancer. Available at:Accessed July 2023.  

  3. National Cancer Institute. Biomarker Testing for Cancer Treatment. Available at:Accessed July 2023.  

  4. National Cancer Institute. Dictionary of Cancer Terms. Definition of Biomarker. Available at:Accessed July 2023.  

  5. Pignon, et al. Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE collaborative group. J Clin Oncol. 2008;26(21):3552-9.

  6. Rodríguez M, et al. Molecular biomarkers in early stage lung cancer. Transl Lung Cancer Res. 2021 Feb;10(2):1165-1185. 

  7. Kerr M., et al. The evolving landscape of biomarker testing for non-small cell lung cancer in Europe. Lung Cancer. 2021;154:161-175.


Biomarker testing checklistBiomarker testing: How results guide lung cancer treatmentBiomarkers in lung cancer: what you need to know

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