Treating lung cancer with a new targeted therapy

Targeted therapy is one of the new scientific approaches to treating cancers, including lung cancer. Doctors may recommend this approach if your lung cancer cells have certain targets that the drugs can work on. You can think of targeted therapies like specialized magnets drawn to cancerous cells that will ignore healthy cells.

Keep reading to learn more about how doctors prescribe targeted therapies to treat lung cancer, their side effects, and cost considerations.

Before targeted therapy to treat lung cancer, a common approach to treating lung cancer was to take one or more chemotherapy drugs. Chemotherapy works by killing cells that multiply rapidly, such as cancer cells. However, chemotherapy drugs can kill other rapidly dividing cells, such as hair cells.

Targeted therapies work to kill cancer cells by a different method: stopping the cells from growing and dividing. The therapies specifically target proteins inside cancer cells that “tell” cancer cells to multiply. Targeted therapies only kill cancer cells, which is why doctors call them “targeted” compared to chemotherapy.

There are no drugs for every type of cancer cell. To see if you’re a good candidate for this treatment, a doctor will usually test your cancer cells for “biomarkers,” which are signs that the drugs could possibly be working on your cancer.

Doctors have primarily used targeted therapies to treat non-small cell lung cancers (NSCLC). About 80 to 85 percent lung cancers are NSCLC, while the others are small cell lung cancers. There are three main types of NSCLC:

  • large cell carcinomas
  • pulmonary adenocarcinomas
  • squamous cell carcinoma

Researchers have identified pathways in lung adenocarcinomas specifically that targeted therapies can address. As a result, some doctors prescribe targeted therapies as first-line treatment over chemotherapy drugs.

The following are examples of targeted therapies to treat lung adenocarcinomas:

The above therapies are small molecule drugs, named for their ability to easily penetrate cancer cells.

Doctors can also prescribe monoclonal antibodies, which are drugs designed to improve how the immune system fights cancer cells or even kills cancer cells. Examples of monoclonal antibodies prescribed to treat NSCLC nivolumab and pembrolizumab.

Targeted therapies are the result of researchers trying to find more effective drugs for treating lung cancer with fewer side effects. However, targeted therapies have side effects, just like chemotherapy drugs.

Perhaps the most worrying effect surrounding targeted therapy for lung cancer is that cancer cells can develop drug resistance. The drugs will stop working to stop the cancer cells from dividing. Some prior targeted therapies have led to drug resistance and disease progression in 10 to 12 months.

Doctors use drug treatment protocols to try to prevent these mutations from occurring. Researchers have also created new drugs, such as osimertinib, that can treat drug-resistant tumours.

Other side effects of targeted therapy for lung cancer includes:

Each drug can also have specific side effects. It is important to discuss these potential effects with your oncologist.

Targeted therapies can be very expensive because they are newer drugs and are used to treat smaller subsets of people. Although lung cancer is a more common cancer, not everyone with lung cancer will respond to targeted therapies. This reduces the amount of drugs produced, which further increases the costs of the current US healthcare system.

Some medications can cost between $5,000 and $10,000 per month, with total annual costs of $100,000. In a study of Medicare-paid costs, therapy with epidermal growth factor receptor (EGFR) and tyrosine kinase inhibitors for non-small cell lung cancer costs on average approximately $8,500 per month. Again, these costs represent what Medicare paid for the drugs.

The costs of cancer treatment can be very high. If you don’t have private insurance, you may want to talk to your doctor about eligibility for Medicaid (a state program for people who meet certain income level requirements) or Medicare (a federal program where you may qualify based on your age or disability).

Targeted therapies for lung cancer have helped people with NSCLC live longer. Success depends on many factors, including how far your cancer has progressed, your type, and how your cancer responds to targeted therapies.

An example of a success rate involves the treatment of EGFR mutations in people with lung adenocarcinoma. People with this mutation who were treated with targeted therapies had an 80% response rate with 10 to 14 months of progression-free survival.

If your doctor prescribes targeted therapies, it’s a good idea to ask how taking them might impact your outlook.

Targeted therapies for lung cancer are a new treatment approach that can help prolong your life when you have lung cancer and minimize unwanted side effects. The challenge now is to identify new treatments that are resistant to mutations or that target new areas of cancer cells so doctors can treat even more people with lung cancer.

If your doctor has diagnosed you with lung cancer, you can discuss targeted therapies with them as treatment options.