Targeted therapies for non-small cell lung cancer

Targeted therapies are drugs that work by targeting the difference between cancer cells and normal cells. There are two types of targeted therapies that are used to treat non-small cell lung cancer:

  • Cancer growth inhibitors – these drugs, known as EGFR antagonists, attach themselves to receptors on cancer cells and prevent the receptors from being activated. This may slow the cancer cells’ growth. You will need tests to show whether this kind of drug will work for you. Erlotinib and gefitinib are drugs that may be used to treat non-small cell lung cancer.
  • Monoclonal antibodies – these drugs recognise certain proteins found in cancer cells. They then ‘lock on’ to the proteins and stop the cancer cells from growing, while causing little damage to normal cells. Bevacizumab is a drug that may be used to treat non-small cell lung cancer.

What are targeted therapies

Targeted therapies work by interfering with the way cancer cells signal or interact with each other, to stop them growing and dividing.

They are usually used to treat advanced non-small cell lung cancer (NSCLC). Clinical trials are still trying to find out if targeted-therapy drugs are helpful in small cell lung cancer.

The two types that are used are cancer growth inhibitors and monoclonal antibodies. These drugs are not all widely available in the UK. Your doctor will tell you if they are suitable for you.

Some people are given targeted therapy drugs in a clinical trial.

Cancer growth inhibitors

Many types of cancer cells have chemicals on their surface called growth factors. These send chemical signals to cells that control how the cancer cells grow and divide. Cancer growth inhibitor drugs used in lung cancer block these signals and prevent the cells from growing.

But they only work for NSCLCs that have an abnormal form of a protein called epidermal growth factor receptor (EGFR).

You have tests for EGFR on the cancer cells (from your lung biopsy or previous surgery) to find out whether these drugs are likely to be helpful.

Erlotinib (Tarceva®), gefitinib (Iressa®) and afatinib (Giotrif®) are all cancer growth inhibitors. They may be used to treat NSCLC that has spread to the area surrounding the lung (locally advanced) or to other parts of the body.

These drugs are given as tablets. The side effects can include a rash, diarrhoea, feeling sick and tiredness.

Erlotinib can be given as a first treatment for lung cancer. It can also be given if the cancer comes back after chemotherapy, or if chemotherapy isn’t working well. We have more information about erlotinib that we can send you.

Gefitinib can also be used as a first treatment for lung cancer. We have more information about gefitinib that we can send you.

Afatinib can be used as a first drug treatment if you have not had another EGFR drug before.

Another cancer growth inhibitor drug called crizotinib (Xalkori®) is sometimes used. For this drug, doctors test the cancer cells for a protein called anaplastic lymphoma kinase (ALK). Nintedanib is another targeted therapy drug that may be given along with the chemotherapy drug docetaxel to people who have already had treatment.

Monoclonal antibodies

Monoclonal antibodies recognise certain proteins (called receptors) found on some types of cancer cells. Bevacizumab (Avastin®) is a monoclonal antibody that attaches to receptors on some lung cancer cells. It stops them connecting with a different protein that helps the cell to grow.

Bevacizumab is not widely available on the NHS. Some people may be given it in a clinical trial.

Back to Targeted (biological) therapies explained

Cancer growth inhibitors

Cancer growth inhibitors block certain chemical signals within cells, which slows down or stops the growth of the cancer.

Monoclonal antibodies

Monoclonal antibodies can attach themselves to cancer cells to prevent them from growing.