Physician preferences of biomarker testing strategies in newly diagnosed stage IV non-small cell lung cancer patients.

Aim: To understand physicians' attitudes and behaviors regarding EGFR testing and retesting strategies in newly diagnosed metastatic non-small cell lung cancer patients. Materials & methods: Oncologists and pathologists completed an online, cross-sectional survey. Results: Most oncologists (73.3%) and pathologists (53.4%) agreed that concurrent testing increases sensitivity for detecting EGFR mutations. Upon tissue insufficiency, oncologists and pathologists reported using liquid biopsy 77.0% and 39.0% of the time, respectively. Tumor accessibility, smoking status, patient willingness and age were key drivers of tissue re-biopsy. Most oncologists reported high confidence in proceeding to first-line therapy based solely on liquid biopsy (60.7-80.0%); fewer pathologists (37.9%) were comfortable with this decision. Conclusion: Variation in physicians' perceptions of testing and retesting highlights the need for greater stakeholder consensus.