Tanja Obradovic, Therapeutic Strategy Lead of Oncology at Novotech, Senior Advisor of Oncology Drug Development at HopeAI, shared a post on LinkedIn:
“As we continue absorbing updates from AACR2026 and start preparing for hearing clinical advances at fast approaching ASCO2026, it is obvious that this year is shaping to be very impactful in light of new options for lung cancer patients. In that context, critical question is how fast these advances are reaching patients and are they available to all who need them? Sharing recent findings and insights about US state of adoption and barriers to overcome.
New Treatment Options for Lung Cancer are Rapidly Emerging-Are They Translated at the Bedside?
As our oncology community still absorbs news from American Association of Cancer Research – AACR2026 and starts preparing for hearing clinical advances at fast approaching American Society of Clinical Oncology (ASCO) meeting, it is obvious that this year is shaping to be very impactful in light of new options for lung cancer patients. These advances are truly eagerly awaited as lung cancer remains a leading cause of cancer-related mortality, with early-stage non–small cell lung cancer (NSCLC) accounting for 40% to 45% of new cancer diagnoses. In that context, critical question is how fast these advances are reaching lung cancer patients and are they available to all who need them?
To answer this question several recent reports on the status in the US paint picture of situation where significant improvements are needed. Advances in biomarker-driven therapies, especially for early disease with numerous molecular targets linked to drug administration or imaging (list of FDA cleared/approved IVDs as of Feb 2026), is posing challenge for US health systems as standard testing utilization in practice is very variable. Real-world data collected from 280 US clinics and published in 2025 shows that less than 60% of patients undergoing perioperative chemoimmunotherapy for non–small cell lung cancer (NSCLC) had EGFR testing completed (Read here), despite evidence that patients with EGFR and ALK alterations gain limited benefit from immunotherapy. In general, field agrees that comprehensive molecular profiling in lung cancer should now be applied at every stage of the disease considering increasing emergence of biomarker-driven therapies in earlier settings especially expanding role of targeted kinase inhibitors in early NSCLC.
Cost and lack of insurance coverage are common barriers to testing because insurance coverage varies across commercial payers, Medicare, and Medicaid. Situation around reimbursement of testing is evolving across US states with over 15 US states enacting laws mandating insurance coverage for comprehensive biomarker testing to improve diagnosis and treatment (Read here). All laws apply to commercial payers; in 12 states, the laws also apply to Medicaid. One state (Arkansas) explicitly excludes Medicaid from the legislation; in 2 others (Louisiana and Rhode Island), there is no mention of Medicaid in the statute. Illinois recently mandated that state-regulated health plans and Medicaid cover biomarker testing supported by medical evidence. In addition, regardless of coverage framework, time needed for ordering and receiving test results, often spanning weeks, also influences utilization in case of fast progressing disease.
Access to new treatment option(s) is not only highly influenced by testing state but also by reimbursement policies, site-of-care restrictions, existence of integrated pharmacy models and availability of this streamlined dispensing approach in community hospital settings. Progress has been evident as recent study found that adoption of novel drugs, including immunotherapy and targeted therapies, for advanced NSCLC has increased significantly in the US, with a high proportion of over 60% patients now receiving these treatments (Read here) but that still leaves large space for improvement in metastatic setting and especially within earlier disease stage where biomarker-driven novel options are making inroads.”
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