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Targeted Therapies for Lung Cancer

If lung cancer is a war and chemotherapy is the nuclear option, then targeted therapy is a team of commandos sneaking behind enemy lines and taking out the general. Chemo works by killing cells that divide quickly—including cancer cells, but a lot of healthy ones, too, which is why there are so many side effects. Targeted therapy, on the other hand, attacks aspects of cancer cells that make them different from normal cells. This makes them easier to tolerate and sometimes more effective than other cancer treatments, and that’s why they’re the hottest area of cancer treatment.

Slowing Growth

Targeted therapies for lung cancer work in a couple different ways. Some go after the blood vessels that feed the cancer cells. Others work on specific gene mutations that cause cancer cells’ growth to spiral out of control. Some drugs target a particular gene (EGFR) that tells cells to divide; in cancer cells, this gene is always “switched on.” Targeted therapies work on these mutations and try to get the cell division back in line.

Benefits and Drawbacks

For at least one type of mutation, targeted therapy can actually work better than traditional chemotherapy, according to Henry Xiong, MD, PhD, of Medical City Fort Worth in Texas. Most targeted gene therapy carries only mild side effects, including skin rashes, mild diarrhea and some fatigue.

Compare that to traditional chemotherapy, which is a “totally different level of toxicity,” says Dr. Xiong. “Patients on traditional chemotherapy have much more profound fatigue, nausea and vomiting, their appetites are usually suppressed, and chemotherapy can suppress white blood cell counts, which puts patients at risk of infection.”

Some targeted therapies are used after other treatments have failed. Still, the cancer will eventually adapt to the therapy and the medicine will stop working. “Eventually the cancer will develop resistance and require a change of treatment,” says Xiong.

Are targeted therapies right for me?

It’s hard to say; it depends on the type of cancer, which mutations it has and how advanced it is. “In general, the rate of mutations is probably 5% or less,” says Xiong. So far, drugs targeting these mutations are given only to people whose tumors have metastasized, or spread throughout the body, aka Stage IV.

Your medical team will be able to run tests to determine if you have mutations that would respond to targeted therapy, and the answer will guide your treatment. “I would do everything possible to have those tests down before we start chemo. If patients have these specific mutations, treatment would be different. It would not be traditional chemotherapy, it would be targeted therapy,” says Xiong.