Which Biomarker Tests Do You Actually Need — and What Do They Cost?

Which tests apply depends entirely on your cancer type — most patients need one to three targeted tests, not a blanket panel. Lung cancer typically starts with PD-L1 plus EGFR/ALK/ROS1; colorectal, gastric and endometrial cancers usually add MSI/MMR; melanoma adds BRAF. A broader NGS panel is added only when the first-line, cheaper tests don't give a clear answer.

This is general, cancer-type-level guidance, not a reading of your own report — your oncologist decides the exact sequence for your diagnosis, stage and prior treatment.

Costs vary widely by test type and are indicative, as of August 2026 — a single IHC stain is far cheaper than a comprehensive genomic panel, and the gap between them is usually the biggest lever families have over the total bill. Exact pricing depends on the accredited laboratory and panel size, and is billed by that laboratory, not by CION.

For many common cancers, one or two targeted, cheaper tests answer the immunotherapy-eligibility question just as well as a large panel. A full panel adds real value mainly when first-line results are inconclusive, when several drug classes are being weighed at once, or when standard testing has already been exhausted — ordering the cheaper test first and escalating only if needed is usually the more cost-efficient sequence.

Sequencing the tests correctly — cheaper, targeted tests before a broad panel — is where families most often save tens of thousands of rupees without losing any clinically useful information. Ask your oncologist to explain, in your specific case, why a panel is or isn't the right next step before agreeing to one.

This section explains what the terms on a typical report mean in general — it is not a reading of your own results, and no online guide safely can be. Bringing the report to your oncologist, along with these questions, gets you a reliable, individual answer faster than searching a number alone.

1. 1

   Identify which tests were actually run

   A report may list one marker or several — check the test names (PD-L1, MSI/MMR, NGS panel, etc.) against what your oncologist ordered and why, so you know what you're looking at.

2. 2

   Note the value and its threshold, not just the number

   A PD-L1 score, an MSI status, or a TMB value only means something against the specific threshold used for your cancer type — the same number can mean different things in different cancers.

3. 3

   Check whether it's tied to an approved indication

   Ask whether the result is linked to a treatment approved for your specific cancer type and stage in India, rather than assuming any positive result opens every immunotherapy option.

4. 4

   Bring the report to your oncologist, not a search engine

   General information explains the terms; only your treating oncologist can weigh your result against your full clinical picture and decide what it means for your plan.

5. 5

   Ask specifically what it does and doesn't support

   A useful question is: "Which drug classes does this result support, and which does it rule out?" — a direct answer is more useful than the raw number alone.

These companion pages go deeper into specific parts of the same testing pathway — worth reading alongside this one before you book a test.

• Is Biomarker Testing Covered by Insurance or Government Schemes? — how Aarogyasri and private insurance actually treat these costs.
• Tumour Mutational Burden (TMB): What a High Score Means — a closer look at one of the tests in the table above.
• IHC, NGS and Liquid Biopsy: Which Test Is Which? — the practical difference between the test types and when each is used.
• Immunotherapy at CION Cancer Clinics — how we coordinate testing, eligibility review and treatment as one pathway.

Backed by the Same Team Managing Your Treatment

Biomarker testing guidance comes from the same oncology team that manages your immunotherapy, not a separate call centre.