Getting the Right Biomarker Test at the Right Time in Lung Cancer Care

In an interview with Pharmacy Times at the 2026 Community Oncology Alliance (COA) Conference, Lisa Lasita, PharmD, MBA, director, pharmacy strategy and operations, Navista, discusses the critical importance of ordering the right biomarker test at the right time to ensure patients with non–small cell lung cancer (NSCLC) receive appropriate targeted therapies. She highlights common barriers, including reimbursement challenges, limited tissue samples, and delays in acting on actionable results. Lasita emphasizes the role of pharmacists in streamlining workflows, interpreting results, and ensuring timely treatment decisions.

Pharmacy Times: From a pharmacy strategy and operations perspective, what are the biggest barriers community oncology practices face when implementing biomarker-driven treatment in NSCLC?

Lisa Lasita, PharmD, MBA: I would say the largest barrier is making sure you are running the right test at the right time. There are numerous biomarkers to test for in the non-small cell lung cancer space, so making sure that you are running the right panel is critical. Once you have the panel and the results back, if there is anything actionable, you need to ensure that action is taken. If the panel identifies a druggable oncogenic target, having a pharmacist involved is key to making sure the appropriate product is selected for that patient at that time.

There are also additional barriers, such as payment and reimbursement from health insurance, ensuring the test is approved and covered, and making sure there is enough tissue from the patient’s biopsy. These are hurdles that community practices are actively working to overcome. However, the primary issue remains ordering the right test at the right time for the right patient.

Pharmacy Times: How can pharmacy leaders better align clinical, operational, and financial workflows to support timely and consistent biomarker testing and targeted therapy use?

Lasita: One important step is leveraging your EHR [electronic health record], along with guidelines and tools available in the market. Oncology is rapidly evolving, and it can be difficult to keep up with constant changes. However, going back to fundamentals can help—making sure you have order sets in your EHR that are easy for providers to use, establishing a strong partnership with a testing company, and ensuring results automatically populate back into the patient’s chart are all key strategies to streamline processes.

From a financial perspective, involving financial navigators, if available, can help address issues related to tests not being covered and reduce the burden on patients.

Pharmacy Times: What role do you see pharmacy strategy teams playing in scaling precision oncology initiatives across community practices, particularly in resource-limited settings?

Lasita: Pharmacists can play a significant role within community oncology practices, especially in precision medicine. When thinking about ordering the right test at the right time, it can be helpful to look back at processes that worked in the past. For example, when immune checkpoint inhibitor toxicities first emerged, practices had to develop structured processes to manage them.

A similar approach can be applied here. Establish a committee or small team to initiate discussions, meet regularly—whether weekly or biweekly—and identify current pain points within the practice. Once those are defined, the team can begin developing solutions. Pharmacists can be actively involved throughout this process.

Another critical role for pharmacists is ensuring that when test results return with actionable findings, appropriate action is taken. The last thing you want is a positive result that is missed, not acted upon, or delayed because the patient has already started another therapy. These scenarios can occur, but strong, well-defined processes can help prevent them. Pharmacy plays a major role in developing and maintaining those processes.

Pharmacy Times: As biomarker-driven care continues to evolve, what key operational or infrastructure investments should practices prioritize now to stay ahead?

Lasita: Having strong partnerships with both a testing company and your EHR system is essential. If those are not in place, they are a good starting point. Once established, ensuring that orders are built into the system, results automatically populate, and manual steps are minimized will help improve efficiency. Leveraging these partnerships allows practices to streamline workflows and improve patient care.