Pathologists order genomic profiling automatically at diagnosis of advanced cancer

Real-world data show that a substantial fraction of patients with advanced NSCLC begin first-line therapy before biomarker results are available or without full testing, forgoing targeted therapy. Reflex testing, ordered by the pathologist at diagnosis on defined tumour types and stages, shortens time to result and increases completeness. Tissue stewardship, funding, and a default panel need agreement. Some regions have adopted reflex testing; most have not.