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Targeted and immunotherapy drugs for lung cancer

These drugs may be used to treat non-small cell lung cancer that has spread. Tests are usually done on the cancer cells to find out if a certain drug is suitable for you.

Targeted therapy drugs interfere with the way cancer cells signal or interact with each other. This can stop them from growing and dividing. Your doctor may recommend a targeted therapy drug after you have already had other treatments. You may have it on its own, or sometimes with chemotherapy.

Targeted therapy drugs used for lung cancer include:

  • Gefitinib (Iressa®).
  • Afatanib (Giotrif®).
  • Erlotinib (Tarceva®)
  • Osimertinib (Tagrisso®)
  • Crizotinib (Xalkori®)
  • Ceritinib (Zykadia®)
  • Nintedanib (Vargatef®).

Immunotherapy drugs help stimulate your immune system to recognise and destroy cancer cells. Pembrolizumab (Keytruda®) and nivolumab (Opdivo®) are immunotherapy drugs. They are both given as a drip (infusion). 

Targeted therapy drugs and immunotherapy drugs can cause different side effects. Some of these can be serious. Your doctor or nurse will talk to you about this. Always tell them about any side effects you have and follow the advice they give you.

Targeted therapy and immunotherapy drugs

Targeted therapy or immunotherapy drugs are used to treat non-small cell lung cancer that has spread outside the lung or to other parts of the body.

Your doctor does tests on the cancer cells called molecular testing. These tests help find out if some of these drugs are suitable options for you. The doctor does the tests on the tissue they take during a biopsy or surgery, or occasionally on a blood test.

The drugs can cause different side effects. Your doctor or nurse will talk to you about this. Always tell them about any side effects you have. They will explain how you can manage them. There are also often things they can do to improve your side effects.

Your doctor might talk to you about having some of these drugs as part of a clinical trial. Newer targeted and immunotherapy drugs are being developed and becoming available.

How targeted therapies work

This animation shows how targeted therapies work and what effect they have on the body.

About our cancer information videos

How targeted therapies work

This animation shows how targeted therapies work and what effect they have on the body.

About our cancer information videos


Targeted therapy drugs

These drugs interfere with the way cancer cells signal or interact with each other. This stops them growing and dividing. The drugs may help:

  • shrink the cancer
  • stop it growing
  • improve your symptoms.

Targeted therapies do not always work for everyone with non-small cell lung cancer. You may need molecular testing on the cancer cells to find out if certain drugs are right for you. Some people who have already had other treatments may not need this.

Your doctor may recommend a targeted therapy drug after you have already had other treatments. They often give the drug on its own, or sometimes with chemotherapy. Or if molecular testing shows targeted therapy drugs are the most effective treatment for you, you might have it as your first treatment.

Not every targeted therapy drug is widely available in the UK. Your cancer doctor or specialist nurse will tell you if they are suitable for you. Different targeted therapy drugs for lung cancer are being tested in clinical trials.


EGFR inhibitors

These drugs block signals from a protein called epidermal growth factor receptor (EGFR). Too much of this protein makes the cancer cells grow. Blocking the signal from EGFR to the cancer cells can stop them growing.

These drugs only work well for cancers with an abnormal form of the EGFR protein. Your doctor can do tests on the cancer cells to check for this change (mutation) of the EGFR gene that makes too much of the protein.

If they find the mutation, they might give you one of these EGFR inhibitor drugs:

You take them as tablets.

After you have had an EGFR inhibitor, you might have a blood test (liquid biopsy) or tests on the cancer cells from another biopsy. These tests look for a certain EGFR mutation called T790M. If they show the mutation, your doctor might give you a drug called osimertinib (Tagrisso®). You take it as a tablet.

Side effects

Common side effects of EGFR inhibitors include:


ALK inhibitors

A small number of people with non-small cell lung cancer have a cancer that has a change (mutation) in a gene. The mutation is called anaplastic lymphoma kinase (ALK). This makes an abnormal protein that can make the cancer cells grow. Molecular testing can check if the cancer cells have this mutation in the ALK gene.

If they have the mutation, your doctor may give you an ALK inhibitor called crizotinib (Xalkori®). After you have had treatment with crizotinib, they might give you another ALK inhibitor called ceritinib (Zykadia®).

You take both these drugs as capsules.

Side effects

Common side effects of ALK inhibitors include:

Even after leaving hospital, I found that sudden activity could leave me gasping. So, I started doing breathing and relaxation exercises and taking short walks, which helped my lung capacity.

Frances


Other targeted therapy drugs

Nintedanib is another targeted therapy drug called a cancer growth inhibitor. People with adenocarcinoma NSCLC may have it with the chemotherapy drug docetaxel. Your doctor might give you nintedanib if the cancer comes back or spreads after your first treatment with chemotherapy.

Nintedanib stops proteins sending signals to cancer cells to grow. It can also stop the cancer cells making new blood vessels. You take it as a capsule.

Side effects

Common side effects of nintedanib include:


Immunotherapy drugs

Immunotherapy drugs help stimulate your immune system to recognise and destroy cancer cells. Certain immunotherapy drugs are available to treat some non-small cell lung cancers. Newer immunotherapy drugs are being developed and becoming available.

Pembrolizumab (Keytruda®) and nivolumab (Opdivo®) are drugs that target a protein (receptor) called PD-1. This is on the surface of T cells, which are part of the immune system. When the PD-1 receptor is blocked, it stimulates the immune system to fight the cancer cells. This can help:

  • shrink the tumour
  • make it grow less quickly.

You have both drugs as a drip (infusion) in the outpatient clinic. You usually have them after you have already had chemotherapy or other targeted drugs. Or if molecular testing shows pembrolizumab is likely to work well for you, you might have it as your first treatment.

Side effects

Some of the common side effects of these immunotherapy drugs are:

Because of the way immunotherapy drugs work, they can make the immune system attack other parts of the body. This is not common, but it can cause serious side effects in the:

  • lungs
  • other organs
  • glands that make certain hormones.

Sometimes the treatment may need to be stopped. You may need to take steroids to suppress your immune system.

Your doctor or nurse will explain all these side effects to you. It is very important to tell them about any side effects you get.

Back to Treating lung cancer

Surgery

Surgery is usually only possible for people with small cell lung cancer when the cancer is found very early and is limited.

Chemotherapy

Chemotherapy is the main treatment for small cell lung cancer. It is also used to treat non-small cell lung cancer.

Radiotherapy

Radiotherapy can be used on its own or along with chemotherapy to treat lung cancer