Lung Cancer. Dr Sarah Khan

Patients with advanced or metastatic lung cancer are treated with systemic treatment. These are therapies that affect the entire body, rather than targeting a specific tumour site. The types of systemic treatments include chemotherapy, targeted therapy and immunotherapy.
These drugs are also used in patients with lung cancer undergoing curative treatment either before surgery (neoadjuvant treatment) or after surgery (adjuvant treatment).

1. Chemotherapy

• Common Chemotherapy Drugs for Lung Cancer:
  • Cisplatin, carboplatin, pemetrexed, taxotere, taxol, vinorelbine

2. Targeted Therapy

Targeted therapies are drugs or other substances that block specific molecules involved in cancer growth. These therapies work by targeting changes (mutations) in the DNA of cancer cells.

• Targeted Drugs for Lung Cancer:
  • EGFR inhibitors (e.g., osimertinib) for cancers with EGFR mutations
  • ALK inhibitors (e.g., crizotinib, alectinib, lorlatanib) for cancers with ALK gene rearrangements
  • ROS1 inhibitors (e.g., crizotinib, entrectinib) for cancers with ROS1 gene fusions
  • BRAF inhibitors (e.g., dabrafenib) for cancers with BRAF mutations
  • MET inhibitors (e.g., capmatinib, tepotinib) for cancers with MET exon 14 skipping mutations
  • RET inhibitors (e.g selpercatinib
  • KRAS inhibitors (e.g.sotarasib) for cancers with KRAs mutations

3. Immunotherapy

Immunotherapy aims to boost the body’s immune system to recognize and attack cancer cells. It’s particularly effective in certain types of lung cancer, especially NSCLC.

• Immunotherapies Used for Lung Cancer:
  • Checkpoint inhibitors (e.g., pembrolizumab, nivolumab, atezolizumab) are the most common. They work by blocking proteins like PD-1, PD-L1, or CTLA-4, which cancer cells use to avoid being attacked by the immune system.