Biomarker-Guided Oncology Practice in Non–Small Cell Lung Cancer: Utilization Patterns, Turnaround Time, and Sector-Associated Access Barriers

Abstract

Background: Biomarker-guided therapy has become standard in advanced non-small cell lung cancer (NSCLC), yet real-world implementation varies across healthcare sectors. Objective: To evaluate biomarker utilization, turnaround time, and structural access barriers among oncology clinicians and to assess whether public-sector practice is associated with higher implementation burden. Methods: A cross-sectional survey of 125 oncology professionals assessed utilization of five NSCLC biomarkers, turnaround time for single-gene and next-generation sequencing testing, and frequency and severity of access barriers. A composite Barrier Burden Score was calculated, and sector-based comparisons were performed using ANOVA. Results: EGFR testing in ≥50% of eligible patients was reported by 64.8%, PD-L1 by 68.8%, and KRAS by 53.6%. NGS turnaround exceeded 21 days in 57.6% of respondents. Patient affordability (61.6%) and absence of reimbursement (52.0%) were the most frequently reported barriers. Public-sector clinicians demonstrated significantly higher Barrier Burden Scores compared with private-sector clinicians (17.96 ± 5.82 vs. 12.23 ± 5.23; mean difference 5.73; p = 0.003). High biomarker utilization (≥4/5 markers) was observed in 40.8%. Conclusion: Biomarker utilization was moderate and sectorally variable, with higher cumulative barrier burden associated with public-sector practice. Financial and infrastructural constraints correspond with implementation disparities and warrant targeted system-level interventions.