Targeted Therapies for Lung Cancer

Woman in bathrobe taking medication in bathroom
Astronaut Images/Caiaimage/Getty Images

New medical treatments called targeted therapies are becoming available for lung cancer. Unlike traditional chemotherapy, these treatments target proteins on cancer cells or target normal cells that have been hijacked by the tumor in its attempts to grow. For that reason, they tend to have fewer side effects that many of the medications used for cancer. Currently, these are used primarily for stage 3 and 4 lung cancer that has not responded to other treatments. Two of the more common targeted therapies include:

  • Tagrisso (osimertinib): Osimertinib is indicated for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R mutations, as detected by an FDA-approved test. It can also be used in patients with metastatic EGFR T790M mutation-positive NSCLC, whose disease has progressed on or after EGFR tyrosine kinase inhibitor (TKI) therapy.
  • Xylori (crizotinib): Between 3% and 5% of people with non-small cell lung cancer have a mutation known as an ALK-EML4 gene rearrangement. For people with this mutation, the medication crizotinib has been found to increase progression-free survival. As with erlotinib, crizotinib often has fewer side effects than traditional chemotherapy and can be taken as an oral medication. Likewise, this mutation if more likely to be found in people who have never smoked. While crizotinib prolongs progression-free survival, resistance invariably develops in time. Thankfully new medications have been found in clinical trials that may work when resistance to crizotinib develops, and it is hoped that in time, ALK-positive lung cancer may be treated as a chronic disease, such as diabetes.

As of 2014, crizotinib has also been approved for people with ROS1 mutations. Like those with ALK mutations, crizotinib increases progression-free survival.

Other medications are currently being evaluated in clinical trials for people who have become resistant to medications for EGFR mutations and ALK mutations, and other "target mutations" are being studied.

Genetic Testing (Molecular Profiling) for Lung Cancer

It's now felt that everyone with advanced lung adenocarcinoma (and some people with squamous cell lung cancer, especially those who have never smoked) should be tested for gene mutations ​and the potential that their tumors will respond to the newer targeted medications. Despite this, many people who may be positive for these mutations and consequently candidates for these medications do not receive the benefit of testing.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.