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. 2026 Jan:211:108887.
doi: 10.1016/j.lungcan.2025.108887. Epub 2025 Dec 23.

Optimizing communication for ultrafast lung cancer biomarker testing: the UTOPIA pilot study

Susana Hernandez  1 , Esther Conde  2 , Marta Alonso  1 , Daniel Curto  1 , Fatima Duran  3 , Abigail Ast  4 , Javier Torres-Jimenez  5 , Helena Bote-de Cabo  5 , Maria Zurera  5 , Javier Baena  5 , Jon Zugazagoitia  6 , Ricardo Garcia-Lujan  7 , Dolores Isla  8 , Javier De Castro  9 , Luis Paz-Ares  10 , Fernando Lopez-Rios  11
Affiliations
Free article

Optimizing communication for ultrafast lung cancer biomarker testing: the UTOPIA pilot study

Susana Hernandez et al. Lung Cancer. 2026 Jan.
Free article

Abstract

Background: Non-small cell lung carcinoma (NSCLC) is a leading example of precision oncology, with a growing number of actionable targets. However, long turnaround times (TAT) for biomarker results can delay optimal treatment decisions. We evaluated whether a streamlined workflow could deliver comprehensive molecular reports within 72 h.

Methods: In this prospective cohort study (UTOPIA protocol), 96 patients with early-stage or advanced NSCLC at Hospital Universitario 12 de Octubre underwent molecular tumor board (MTB)-centered triage, automated NGS processing, and integrated data review. TAT was defined (in working days) from MTB triage to electronic report validation. Communication was supported by daily operational huddles and intralaboratory pre-MTB meetings using a standardized checklist.

Results: All 96 NGS reports met the 72-hour TAT target (100%). The NGS failure rate was 1%. Potentially actionable genomic alterations were identified in 45.8% of patients, most frequently EGFR (24%) and KRAS G12C (8.3%). Other targetable alterations included six ALK fusions (6.3%), four MET exon 14 skipping mutations (4.2%), two BRAF V600E mutations (2.1%), and one RET fusion (1%).

Conclusion: An ultrafast biomarker testing workflow for lung cancer, enabled by MTB-driven triage and structured team communication, can reliably generate comprehensive molecular reports within 72 h. This approach may reduce TAT-related treatment delays and support timely biomarker-guided therapy for patients with NSCLC.

Keywords: Artificial intelligence; Biomarkers; Checklist; Molecular tumor boards; Non-small cell lung cancer.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Dr. Hernandez reports receiving grants or contracts from Thermo Fisher, AstraZeneca and Roche. She has received payment or honoraria for lectures, presentations, or speakers’ bureau from Pfizer, Roche, Thermo Fisher, AstraZeneca, Johnson & Johnson and Lilly. She has received support for attending meetings or travels from Roche, AstraZeneca and Thermo Fisher. Dr. Conde reports receiving grants or contracts from Thermo Fisher, AstraZeneca and Roche. She has received payment or honoraria for lectures, presentations, or speakers’ bureau from Pfizer, Roche, Thermo Fisher, AstraZeneca, Lilly, and Johnson & Johnson. She reports receiving consulting fees from Roche, Johnson & Johnson, and AstraZeneca. She has received support for attending meetings or travels from Roche, AstraZeneca, Thermo Fisher and Johnson & Johnson. Marta Alonso reports receiving grants or contracts from Thermo Fisher, AstraZeneca and Roche. She has received payment or honoraria for lectures, presentations, or speakers’ bureau from Roche, AstraZeneca and Pfizer. Javier Torres-Jimenez has served as a consultant for Roche. He has received support for attending meetings or travels from BMS, AstraZeneca, Pfizer and Oncomatryx. Dr. Baena reports receiving grants or contracts from Spanish Society Medical Oncologist (SEOM). He has served as a consultant for BMS and Roche. He reports payment or honoraria for lectures, presentations, or speakers’ bureau from Regeneron, AstraZeneca, BMS, Janssen and Pfizer. He has received support for attending meetings or travels from MSD. Dr. Zugazagoitia has received grants or contracts from Pfizer, AstraZeneca and Roche. He has served as a consultant for Amgen, Boehringer Ingelheim, Janssen, Pierre Fabre, Takeda, Sanofi, BMS, AstraZeneca, MSD, Roche, Pfizer, Novartis, and NanoString. He reports payment or honoraria for lectures, presentations, or speakers’ bureau from Amgen, Boehringer Ingelheim, Janssen, Pierre Fabre, Takeda, Sanofi, BMS, Astra Zeneca, MSD, Roche, Pfizer, Novartis, and NanoString. He has received support for attending meetings or travels from Amgen, Boehringer Ingelheim, Janssen, Pierre Fabre, Takeda, Sanofi, BMS, Astra Zeneca, MSD, Roche, Pfizer, Novartis and NanoString. Dr. Isla has served as a consultant for Roche, AstraZeneca, BMS, MSD, Johnson & Johnson, Pharmamar, Pfizer, AbbVie and Amgen. She has received payment or honoraria for lectures, presentations, or speakers’ bureau from Pfizer, Johnson & Johnson, BMS, MSD, AstraZeneca, Roche, Pharmamar and Lilly. She has received support for attending meetings or travels from MSD, AstraZeneca, Roche, Pfizer and Johnson & Johnson. Dr. De Castro reports receiving grants or contracts from GSK, AstraZeneca, BMS, MSD and Roche. He has served as a consultant for AstraZeneca, BMS, Roche, MSD, Boehringer Ingelheim, Janssen, Lilly, Sanofi, Takeda, Pfizer, GSK, Gilead and Beigene. He has received payment or honoraria for lectures, presentations, or speakers’ bureau from AstraZeneca, BMS, Roche, MSD, Pfizer, Janssen, Takeda and Sanofi. Dr. Paz-Ares reports receiving grants or contracts from MSD, AstraZeneca, Pfizer and BMS. He reports receiving consulting fees from Lilly, MSD, Roche, Pharmamar, Merck, AstraZeneca, Novartis, Servier, Amgen, Pfizer, Sanofi, Bayer, BMS, Mirati, GSK, Janssen, Takeda and Daichii Sankyo. He has received payment or honoraria for lectures, presentations, or speakers’ bureau from AstraZeneca, Janssen, Merck and Mirati. Dr. Lopez-Ríos reports receiving grants or contracts from Thermo Fisher, AstraZeneca, Janssen, Roche, Lilly and Pfizer. He has served as a consultant for Roche, AstraZeneca, AbbVie, MSD, BMS, Janssen and Daiichi Sankyo. He has received payment or honoraria for lectures, presentations, or speakers’ bureau from Roche, Pfizer, Lilly, Thermo Fisher, AstraZeneca, Bayer, Merck, MSD, Novartis, Janssen, Daiichi Sankyo, Regeneron and Boehringer Ingelheim. He has received support for attending meetings or travels from MSD, Roche and AstraZeneca. He reports a leadership position as Chair of the International Association for the Study of Lung Cancer (IASLC) Pathology Committee. The remaining authors declare no conflict of interest].

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