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NSCLC Biomarker Cheat Sheet

Essential biomarkers for non-small cell lung cancer — actionable mutations, immunotherapy markers, and the targeted therapies they unlock.

Biomarker	Frequency	Type	FDA-Approved Targeted Therapies
EGFR	15–25%	Targeted	Osimertinib (Tagrisso), erlotinib, afatinib, dacomitinib
ALK	3–7%	Targeted	Alectinib (Alecensa), lorlatinib, brigatinib, crizotinib
ROS1	1–2%	Targeted	Crizotinib, entrectinib, lorlatinib
BRAF V600E	1–3%	Targeted	Dabrafenib + trametinib (Tafinlar/Mekinist)
KRAS G12C	13%	Targeted	Sotorasib (Lumakras), adagrasib (Krazati)
MET exon 14	3–4%	Targeted	Capmatinib (Tabrecta), tepotinib (Tepmetko)
RET	1–2%	Targeted	Selpercatinib (Retevmo), pralsetinib (Gavreto)
NTRK	<1%	Targeted	Larotrectinib (Vitrakvi), entrectinib (Rozlytrek)
HER2 (ERBB2)	2–4%	Targeted	Trastuzumab deruxtecan (Enhertu)
PD-L1	~30% high	Immuno	Pembrolizumab, atezolizumab, nivolumab ± ipilimumab
TMB	Varies	Immuno	TMB-High (≥10 mut/Mb): pembrolizumab (tissue-agnostic)

Critical: All patients with advanced NSCLC (adenocarcinoma or non-squamous histology) should receive comprehensive biomarker testing before starting first-line therapy. NCCN guidelines recommend broad molecular profiling including EGFR, ALK, ROS1, BRAF, KRAS, MET, RET, NTRK, HER2, PD-L1, and TMB. Results can take 2–3 weeks — discuss timing with your oncologist.

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