Pathologists are taking on a larger role in managing non-small cell lung cancer, moving beyond diagnosis to help guide treatment decisions. They now act as “first responders,” automatically starting molecular testing as soon as cancer is detected, which helps patients begin therapy more quickly. They also assess whether small biopsy samples have enough tumor material for key tests like PD-L1.
They choose the most appropriate testing methods based on the sample, including Next-Generation Sequencing, FISH, or Immunohistochemistry. Because tissue samples are often limited, especially in advanced disease, pathologists must prioritize the most important biomarkers needed for first-line treatment and adjust strategies if sample quality is poor.
Challenges remain, such as fragmented testing workflows, delays in validating new biomarkers, and gaps in understanding test coverage. Experts emphasize better coordination between pathology and oncology teams, along with smarter use of tissue and blood-based testing, to ensure patients receive timely and effective care.