Aim: Tyrosine kinase inhibitors (TKIs) targeting the epidermal growth factor receptor (EGFR) can significantly improve PFS for patients with advanced NSCLC harboring activating EGFR mutations (EGFRM+ aNSCLC) compared to chemotherapy. The German lung cancer guidelines recommend EGFRM testing for aNSCLC stage IIIB/IV before therapy. If an activating mutation is detected, an EGFR TKI is recommended as 1st line therapy. Two and four years after the 1st EGFR TKI (Gefitinib, 2009 in Europe) was approved for EGFRM+ aNSCLC, we studied whether physicians have implemented EGFRM testing into their clinical routine. Methods: We surveyed EGFRM testing in specialized lung clinics, academic and non-academic clinics and independent medical oncology offices. Two surveys recorded 1) frequency and selection criteria for EGFRM testing, 2) logistics of test initiation, histological and cytological sample preparation, and 3) barriers of EGFRM testing. Results: In 2012, 60% of patients with aNSCLC stage IIIB/IV underwent an EGFRM analysis prior to treatment initiation. This number increased to 78% by the end of 2014. 12.5% and 11.7% of the patients were EGFRM positive in 2012 and 2014, respectively. Interestingly, in 2012, the lowest test rate of 38% was found in lung clinics but increased to 79% between surveys. Test rates had hardly changed in other institutions. Reasons against testing included cost, insufficient sample quantity and quality and pressure to treat. Selection criteria for testing were histology (∼96%), smoking habits (∼48%), gender (∼27%), performance status (∼22%) and age (∼18%). A total of 11.3% and 8.9% of all patients were treated with EGFR TKIs as 1st line therapy in 2012 and 2014, respectively. In 2014, we added a sub-survey asking for the testing of KRAS, ALK and ROS1. ALK testing was most frequent with 53% followed by KRAS, 39%, and ROS1, 14%. Conclusions: Our surveys show that mutational analysis has already played an important role in 2012 for the treatment of NSCLC and that awareness for testing has increased recently. However, the data also indicate that there is still room for improvement regarding testing rate and the use of EGFR TKIs in line with German Lung Cancer Guidelines for EGFRM+ aNSCLC. Disclosure: H. Ostermann and D. Ukena: Received financial support from AstraZeneca GmbH for the presented research. S. Radke, A. Freitag and S. Hörnig: Employed by AstraZeneca GmbH.