Lung Cancer (non-small cell) Overview

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Treating Lung Cancer - Non-Small Cell TOPICS

Targeted drugs for non-small cell lung cancer

As researchers have learned more about the changes in lung cancer cells that help them grow, they have developed newer drugs that target these changes. These targeted drugs work differently from standard chemotherapy (chemo) drugs. They sometimes work when other cancer drugs don’t, and they often have different (and less severe) side effects. At this time, they are most often used for advanced lung cancers, either along with chemo or by themselves.

Drugs that target tumor blood vessel growth (angiogenesis)

For cancer cells to grow, they must form new blood vessels to feed the tumor. The drug bevacizumab (Avastin®) can keep new blood vessels from forming. It has been shown to help people with advanced lung cancer live longer when given along with chemo. But it can cause serious bleeding, so it can’t be used for patients who are coughing up blood or are taking certain medicines. Other possible side effects include high blood pressure, low white blood cell counts, slow wound healing, holes forming in the intestines, heart problems, and an increased risk of blood clots.

Drugs that target EGFR

Epidermal growth factor receptor (EGFR) is a protein on the surface of cells that normally helps them grow and divide. Some lung cancer cells have too much EGFR, which helps them grow faster.

Targeted drugs such as erlotinib (Tarceva®), cetuximab (Erbitux®), and afatinib (GilotrifTM) block EGFR from telling the cell to grow. Some are taken as pills, while others must be injected into a vein.

The side effects of these drugs tend to be milder than those of most chemo drugs. The most bothersome side effect for many people is an acne-like rash on the face and chest, which in some cases can lead to skin infections. Other side effects can include diarrhea, loss of appetite, and feeling tired.

For more details about the skin problems that can result from anti-EGFR drugs, see our document Targeted Therapy.

Drugs that target the ALK gene

About 5% of non-small cell lung cancers have a problem in a gene called ALK. The drugs crizotinib (Xalkori®) and ceritinib (Zykadia) can help patients with lung cancers that have the ALK gene change. Crizotinib is generally used first. Then ceritinib is used if crizotinib stops working or didn’t work in the first place

The most common side effects are mild and depend on which drug is used. They can include nausea and vomiting, diarrhea, constipation, swelling, fatigue, and eye problems. Some other severe side effects can occur, as well. Ask your doctor what you can expect.

For more information on the targeted drugs used to treat non-small cell lung cancer, see “Targeted therapies for non-small cell lung cancer” in our detailed guide, Lung Cancer (Non-small Cell).

Last Medical Review: 09/05/2013
Last Revised: 04/30/2014