OncLive® On Air S15 Ep45: Early, Reflex Biomarker Testing Is Critical to Optimizing NSCLC Treatment Decisions Across Disease Stages: With Adam Fox, MD, and Cynthia A. Schandl, MD, PhD
Jan 30, 2026
Cynthia A. Schandl, MD, PhD, medical director of clinical labs and pathology division lead at MUSC, shares her pathology-centered perspective. She talks about early reflex biomarker testing for NSCLC. She explains pathology workflows that speed genomic profiling. She covers specimen adequacy, test selection, and coordination challenges across treatment modalities.
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Test At Diagnosis To Guide Treatment
- Biomarker testing or genomic profiling should ideally occur at diagnosis for most NSCLC patients to guide treatment decisions.
- Testing use has expanded from metastatic disease into earlier stages to inform neoadjuvant or adjuvant therapy.
Implement Reflex Testing Workflows
- Pathology teams should implement reflex testing workflows so molecular profiling starts automatically after diagnosis.
- Involve molecular genetic pathology to match tests to specimen type and maximize actionable results.
Pathologist Role Cuts Treatment Delays
- Pathologists are central to rapid testing because they assess sample adequacy and can initiate testing quickly.
- Delays occur when tests wait for oncologist orders and samples return to archive, slowing therapy start.