Lung cancer is a leading cause of cancer-related deaths globally. The treatment options for lung cancer have evolved significantly over the years, and targeted therapies and immunotherapies have emerged as promising treatment options for patients with lung cancer. These treatments are designed to target specific genetic mutations or proteins that are involved in the growth and spread of cancer cells, or to boost the immune system’s natural ability to fight cancer.
Targeted therapies for lung cancer:
Targeted therapies are drugs that specifically target certain proteins or genetic mutations that are involved in the growth and spread of cancer cells. These drugs are typically used for patients whose tumors have specific genetic mutations or abnormalities. Some targeted therapies that are currently available for lung cancer include:
EGFR inhibitors: EGFR (epidermal growth factor receptor) inhibitors are drugs that block the activity of the EGFR protein, which is often mutated in non-small cell lung cancer (NSCLC). Examples of EGFR inhibitors include gefitinib (Iressa), erlotinib (Tarceva), and afatinib (Gilotrif). These drugs are most effective in patients with NSCLC who have an EGFR mutation.
ALK inhibitors: ALK (anaplastic lymphoma kinase) inhibitors are drugs that block the activity of the ALK protein, which is often mutated in NSCLC. Examples of ALK inhibitors include crizotinib (Xalkori), ceritinib (Zykadia), and alectinib (Alecensa). These drugs are most effective in patients with NSCLC who have an ALK fusion gene.
ROS1 inhibitors: ROS1 (c-ros oncogene 1) inhibitors are drugs that block the activity of the ROS1 protein, which is often mutated in NSCLC. Examples of ROS1 inhibitors include crizotinib (Xalkori) and entrectinib (Rozlytrek). These drugs are most effective in patients with NSCLC who have a ROS1 fusion gene.
BRAF inhibitors: BRAF (v-raf murine sarcoma viral oncogene homolog B1) inhibitors are drugs that block the activity of the BRAF protein, which is often mutated in NSCLC. Examples of BRAF inhibitors include dabrafenib (Tafinlar) and trametinib (Mekinist). These drugs are most effective in patients with NSCLC who have a BRAF V600E mutation.
Immunotherapies for lung cancer:
Immunotherapies are drugs that help the immune system recognize and attack cancer cells. These drugs work by either boosting the activity of immune cells or by blocking proteins that inhibit immune cell activity. Immunotherapies that are currently available for lung cancer include:
PD-1 inhibitors: PD-1 (programmed death-1) inhibitors are drugs that block the activity of the PD-1 protein, which is often overexpressed in cancer cells and inhibits the activity of T cells. Examples of PD-1 inhibitors include pembrolizumab (Keytruda), nivolumab (Opdivo), and cemiplimab (Libtayo). These drugs are most effective in patients with NSCLC who have high levels of PD-L1 expression.
PD-L1 inhibitors: PD-L1 (programmed death-ligand 1) inhibitors are drugs that block the activity of the PD-L1 protein, which is often overexpressed in cancer cells and inhibits the activity of T cells. Examples of PD-L1 inhibitors include atezolizumab (Tecentriq), durvalumab (Imfinzi), and avelumab (Bavencio). These drugs are most effective in patients with NSCLC who have high levels of PD-L1 expression.
CTLA-4 inhibitors: CTLA-4 (cytotoxic T-lymphocyte-associated protein 4) inhibitors are drugs that block the activity of the CTLA-4 protein, which is involved in regulating the activity of T cells. Examples of CTLA-4 inhibitors include ipilimumab (Yervoy) and tremelimumab (not yet approved for lung cancer). These drugs are typically used in combination with PD-1 or PD-L1 inhibitors.
CAR T-cell therapy: CAR T-cell therapy is a type of immunotherapy that involves genetically modifying a patient’s T cells to recognize and attack cancer cells. This therapy is still in the early stages of development for lung cancer and has not yet been approved for widespread use.
Overall, targeted therapies and immunotherapies have shown great promise in treating lung cancer, particularly in patients with specific genetic mutations or high levels of PD-L1 expression. However, these treatments are not without side effects, and patients should work closely with their healthcare team to determine the best treatment plan for their individual needs.
