Can lung cancer become a chronic condition? Inside targeted therapies

Lung cancer is still the number one cause of cancer deaths, but thanks to tremendous advances in targeted therapies, survival rates are significantly improving for people with newly diagnosed and recurrent lung cancer.

In an increasing number of cases, lung cancer can become more of a chronic condition than a fatal disease, and new medications on the horizon are providing even more hope for the future.

How targeted therapies pinpoint and block cancer drivers

Targeted therapies are designed to attack the mutations that are driving the cancer cell growth.

Specifically, targeted therapies attack specific genetic mutations within the cancer cells — somatic mutations in tumors rather than hereditary mutations found in the patient’s own genes, explained Endeavor Health thoracic surgeon Seth Krantz, MD.

Patients first undergo biomarker testing with tissue and/or blood biopsies to determine the nature of their individual cancer and whether they are a match for a targeted therapy, added Dr. Krantz.

Key driver mutations explained

Identifying the driver mutation fueling a tumor's growth allows doctors to match patients with targeted therapies tailored to their individual cancer.

1. EGFR (epidermal growth factor receptor): One of the most common driver mutations that has been known for several years is EGFR. EGFR mutations are found in about 10-15% of lung cancers in the U.S. and are more common in never-smokers and Asian females. The newest generation of EGFR-positive medications are often given as adjuvant therapy after surgery to remove tumors. A recent study showed that this therapy, given with chemotherapy or alone, improved the survival rate from 73% to 85%.

   “This targeted therapy has shown benefits for treating every stage and it is typically much better tolerated than chemotherapy in terms of side effects,” said Dr. Krantz. While targeted therapy medications are not without side effects, they are often fewer than those associated with traditional chemotherapy.

2. ALK (anaplastic lymphoma kinase): Another common mutation is ALK. Patients with ALK-positive lung cancer are now often treated with an ALK inhibitor to block the ALK fueled cancer cell growth. This targeted therapy has also been shown to dramatically reduce risk of recurrence and mortality in patients with the ALK mutation.
3. RET (rearranged during transfection): The RET fusion gene is a recognized biomarker found in roughly 1-2% of lung cancers. It is more common in younger patients and never-smokers with non-small cell lung cancer. Targeted therapies for RET fusion gene lung cancers have shown a huge benefit in survival rates, said Dr. Krantz.

The role of advanced molecular testing in personalized treatment

Next-generation sequencing (NGS) molecular testing of tumor tissues is now the standard following a lung cancer diagnosis to determine if targeted mutations are present and guide treatment selection.

For patients who do not have an identified mutation, immunotherapy may be a promising option, in addition to surgery and/or chemotherapy.

“The whole field of targeted therapy has changed how we treat lung cancer and has provided tremendous improvements in outcomes and survival for patients. We are expecting even more driver mutation therapies as research is ongoing and drug development is promising,” said Dr. Krantz.

Why early screening remains essential for lung cancer outcomes

While these advancements are encouraging, the best strategy to fight lung cancer is still to increase screening and early detection, emphasized Dr. Krantz, who has been a longtime advocate for early screening.

Learn how advanced technology enables earlier lung cancer diagnosis.