Targeted therapy is one of several new scientific approaches to treating cancers, including lung cancer. Doctors may recommend this approach if your lung cancer cells have certain targets that medications can work on. You can think of targeted therapies like specialized magnets drawn to cancer 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 lung cancer treatment approach was taking one or more chemotherapy medications. Chemotherapy works by killing rapidly multiplying cells, such as cancer cells. However, chemotherapy medications can kill other rapidly dividing cells, such as hair cells.

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

There aren’t medications for every cancer cell type. To see if you’re a good candidate for this treatment, a doctor will usually test your cancer cells for “biomarkers,” which are signs the medications could possibly work on your cancer.

Talking with your doctor about targeted therapy

Your doctor should consider and explain your treatment options based on the cancer type you have. When your doctor first diagnoses you with cancer, you can ask if your cancer type could potentially respond to targeted therapy. This may require further testing of your tumor cells.

It’s important to remember that targeted therapy can’t treat every lung cancer cell type and has side effects. Only your doctor and oncology team will be able to tell if targeted therapy could be a useful part of your treatment plan.

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Doctors have primarily been using targeted therapies to treat non-small cell lung cancers (NSCLCs). An estimated 80 to 85 percent of lung cancers are NSCLC, while the remainder are small-cell lung cancer. Three major NSCLC types exist:

  • large cell carcinomas
  • lung adenocarcinomas
  • squamous cell carcinomas

Researchers have identified pathways in lung adenocarcinomas specifically that targeted therapies can treat. As a result, some doctors are prescribing targeted therapies as a first-line treatment over chemotherapy medications.

Examples of targeted therapies to treat lung adenocarcinomas include:

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

Doctors also may prescribe monoclonal antibodies, which are medications designed to enhance the way the immune system fights cancer cells or even kill the 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 lung cancer treatment drugs with fewer side effects. However, targeted therapies have side effects just as chemotherapy drugs do.

Perhaps the most concerning effect surrounding targeted therapy for lung cancer is that cancer cells can develop resistance to the medications. The medications will stop working to keep cancer cells from dividing. Some earlier targeted therapies resulted in drug resistance and disease progression in 10 to 12 months.

Doctors use drug treatment protocols to try and keep these mutations from occurring. Researchers have also created new medications, such as osimertinib, which can treat drug-resistant tumors.

Other side effects of targeted therapy for lung cancer include:

Each medication may also have specific side effects. It’s important to discuss these potential effects with your oncologist.

Targeted therapies can be very expensive, as they’re newer drugs and are used to treat smaller subsets of people. While lung cancer is a more common cancer, not everyone with lung cancer will respond to targeted therapies. This makes the amount of medications produced smaller, which further increases the costs in the current U.S. healthcare system.

Some medications may cost anywhere from $5,000 to $10,000 per month, with total costs per year 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 about $8,500 per month. Again, these costs represent what Medicare paid for the medications.

Cancer treatment costs can be very high. If you don’t have private insurance, you may wish to talk with your doctor about qualifying for Medicaid (a state-based program for individuals who meet certain income-level requirements) or Medicare (a federal program where you can qualify based on age or disability).

Targeted therapies for lung cancer have helped people with NSCLC live longer lives. The success depends upon many factors, including how advanced your cancer is, what type you have, and how your cancer responds to targeted therapies.

One success rate example regards the treatment for EGFR mutations in those with lung adenocarcinoma. People with this mutation who were treated with targeted therapies had a response rate of 80 percent 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 could impact your outlook.

Living with lung cancer

When you’re diagnosed with lung cancer, getting support can help you navigate the many difficult emotions that often accompany a cancer diagnosis. Some of the organizations that may help include:

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Targeted therapies for lung cancer are a newer treatment approach that may help to extend your life when you have lung cancer as well as minimize unwanted side effects. The challenges now are to identify new treatments that are mutation resistant or that target new cancer cell areas so doctors can treat even more people with lung cancer.

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