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As ASCO 2021 Spotlights Biomarkers, New InCrowd Data shows 80% of US Oncologists Anticipate Broader Liquid Biomarkers Use, Despite Insurance Barriers

June 2, 2021

While crediting life science firms that present a strong and transparent approach to biomarkers, 42% say they need more clear and compelling data to expand biomarker orders

WATERTOWN MA June 2, 2021—With oncology biomarker testing advances featuring prominently in this week’s American Society of Clinical Oncology (ASCO 2021) agenda, new data show that 80% of US oncologists surveyed think liquid biomarker testing in the solid tumor space will increase from the estimated one-third of their solid tumor testing today. While 71% cite insurance coverage as the biggest barrier to biomarker targeted testing, oncologists see an important role for the pharmaceutical industry, with 42% of oncologists saying access to more clear and compelling data would motivate them to order more biomarker testing outside the existing standard tests.


Data are from the Oncology Biomarker Testing report from InCrowd, the pioneer for real-time, high-quality primary market intelligence for the life science industry.

“Biomarkers are an area of tremendous innovation, where 34% of oncologists in our report say they want more biomarker R&D,” said Daniel S. Fitzgerald, CEO of Apollo Intelligence (Apollo), the global insights innovator for the life science industry and parent company to InCrowd. “Despite insurance reimbursement barriers and limited indications, physicians see the potential for helping patients to get faster results with less invasive liquid testing for certain tumor types. Our respondents have shared that pharmaceutical leaders who successfully demonstrate and communicate the efficacy of targeted tests, can help increase adoption of these promising diagnostic tools.”

At present 93% of oncologists in the report order initial biomarker tests upon diagnosis, and 61% order non-standard biomarker tests after first-line treatment failure. Only 13% order testing at first symptoms. In verbatim remarks, most oncologists mention that they are upfront with patients about the low incidence of rare biomarker presence and reassure them that plenty of other effective testing options exist.

“I let them know that the chances are low that they have a targetable mutation, so they don’t get their hopes up unreasonably high. However it is impossible – and not advisable – for them NOT to get their hopes up,” says a Maryland-based oncologist working in a community-based practice.


Oncologists report that, on average, 62% of the biomarker tests they order are broad-reaching, vs. 38% that are targeted tests. Two-thirds of the solid tumor biomarker tests they order are tissue tests, while 28% are blood tests, 2% are saliva tests, and 2% are other liquid tests. Three quarters of oncologists use preferred off-site labs for biomarker test analysis, while 25% use on-site labs at their hospitals.

Among the 80% of respondents who believe liquid biomarker testing will increase over time, 61% say they’re most excited about the ease of obtaining a sample, and less invasive nature of the testing. One quarter (26%) cite avoiding biopsies and associated complications as the top anticipated benefit of increased liquid testing, with 25% citing the benefits of personalized and targeted decision-making.

Physicians report that the best way that pharma companies can help increase liquid testing is by improving cost and access (40%). Given that peer reviewed papers (82%) and conference presentations (72%) are the top ways oncologists learn about new biomarker tests, 42% say that learning about clear and compelling evidence and data would motivate them to order additional testing.

Respondents note that the pharmaceutical companies that do the best job of communicating about biomarker tests have a strong and transparent approach to marketing, education and data publishing, particularly around evidence-based data that can provide cost-justification to insurers and updates on new options and costs.

Data in the Oncology Biomarkers Testing report were sourced April 15-21, 2021 from InCrowd’s proprietary panel of healthcare professionals. The n=100 respondents included US oncologists, each of whom completed a 5-minute MicroSurvey. Respondents practice at community hospitals, academic hospitals, and office-based practices, where they are treating an average of 227 patients per month and ordering an average of 85 biomarker tests per month. For more information download the full report here.

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