What Is Targeted Therapy?
When most people think about cancer treatment, chemotherapy or radiation usually comes to mind. But what if we could go deeper—zoom in on the exact faulty wiring inside cancer cells and shut it down? That’s the core idea behind targeted therapy.
Unlike chemo, which acts like a bomb affecting both healthy and cancerous cells, targeted therapy is more like a smart missile. It locks onto specific molecules involved in the growth and spread of cancer, minimizing collateral damage. Think of it as treating cancer from the inside out.
How Targeted Therapy Works in Lung Cancer
Lung cancer isn’t just one disease. It’s a group of diseases caused by various mutations in the DNA of lung cells. Targeted therapy focuses on these mutations—like EGFR, ALK, ROS1, or BRAF.
Each of these genetic changes sends “grow faster” messages to the cancer cell. Targeted drugs block these signals, slowing or even halting the tumour’s growth. It’s like cutting the power supply to a rogue machine.
Who Is Eligible for Targeted Therapy?
So, who gets access to this high-precision weapon?
Not everyone with lung cancer is a candidate. First, doctors need to run biomarker tests or molecular profiling. These tests look for gene mutations or rearrangements driving the tumour’s growth. If the tumour carries one of these “driver mutations,” targeted therapy could be on the table.
Unfortunately, about 30-40% of patients with non-small cell lung cancer (NSCLC) don’t have any actionable mutations—at least with current technology. But that number is shrinking as research uncovers more targets.
Types of Targeted Therapies for Lung Cancer
Lung cancer therapies have come a long way. Here are some of the most common targeted treatments:
- EGFR Inhibitors (e.g., osimertinib, erlotinib)
- ALK Inhibitors (e.g., alectinib, crizotinib)
- ROS1 Inhibitors (e.g., entrectinib)
- BRAF Inhibitors (e.g., dabrafenib)
- MET, RET, and HER2 Inhibitors (emerging treatments)
There are also monoclonal antibodies, such as bevacizumab, that block blood supply to tumours, essentially starving them.
The list keeps growing, which is a hopeful sign.
Benefits of Targeted Therapy
Let’s be honest: traditional treatments often come with a heavy price—nausea, hair loss, fatigue. Targeted therapy changes the game in many ways:
- Better precision = less damage to healthy cells
- Fewer side effects compared to chemotherapy
- Convenient administration, often in the form of pills
- Improved survival rates, especially progression-free survival (PFS)
It’s not perfect, but for many, it feels like a second chance.
Limitations and Challenges
Still, every silver lining comes with a cloud.
- Not all patients have identifiable mutations.
- Some therapies stop working over time.
- Cost can be sky-high, and not all treatments are available everywhere.
In some countries, access depends on health insurance or government approval. This can be frustrating for patients who know there’s a drug that works—but just can’t get it.
Side Effects to Watch Out For
No treatment is free of side effects, and targeted therapy is no exception. Common issues include:
- Skin rashes
- Diarrhoea
- Fatigue
- Liver enzyme changes
Side effects vary depending on the specific drug and mutation. For example, EGFR inhibitors often cause acne-like skin problems. Sounds mild? It can be emotionally distressing. That’s why a supportive care team matters.
Resistance: Why Targeted Therapy May Stop Working
Sadly, even when a drug works at first, cancer can be tricky. Over time, many tumours develop resistance. This can happen due to:
- New mutations (e.g., T790M in EGFR)
- Tumour changes that activate alternative growth pathways
But there’s hope: researchers have developed second- and third-generation inhibitors to overcome this resistance. It’s an arms race between science and cancer.
Combining Targeted Therapy with Other Treatments
What if one weapon isn’t enough?
More oncologists are combining targeted therapy with other options, like immunotherapy or chemotherapy. Early studies show that this can boost effectiveness and slow resistance.
It’s a strategy still being fine-tuned, but it holds a lot of promise.
The Future of Targeted Therapy in Lung Cancer
Here’s where it gets exciting.
New targets are being discovered. Drugs are being designed to work against rare and complex mutations. Liquid biopsies now allow doctors to detect mutations from a simple blood draw. And AI tools are helping predict which therapies might work best.
We’re moving closer to a future where treatment is as unique as your DNA.
Patient Stories: Real-Life Impact of Targeted Therapy
Meet Julie, a 52-year-old mother of three. Diagnosed with stage 4 lung cancer and an EGFR mutation, she was given a targeted drug instead of chemo. Two years later, she’s back to gardening, travelling, and chasing her grandkids.
Then there’s Arman, a young engineer whose ALK-positive lung cancer responded dramatically to crizotinib. He’s working full-time and just ran his first 10K.
These are not miracles. They’re science in action.
FAQs About Targeted Therapy
Is targeted therapy a cure?
Not usually. It controls the disease, sometimes for years. But most patients still require ongoing treatment or switching drugs over time.
Can I get targeted therapy if I’m already on chemo?
Yes, but you’ll need to undergo biomarker testing first. Your oncologist can then discuss whether it’s time to pivot.
Does insurance cover it?
Coverage varies. In some countries, national health systems include certain drugs. In others, it may depend on private insurance or out-of-pocket payment.
References
- “Targeted Therapies in Lung Cancer: Questions Remain,” Cancer Network, 2022. https://www.cancernetwork.com/view/targeted-therapies-in-lung-cancer-questions-remain
- “Lung Cancer Treatment (PDQ®) – Patient Version,” National Cancer Institute, 2023. https://www.cancer.gov/types/lung/patient/lung-treatment-pdq
- “Targeted Therapy for Non-Small Cell Lung Cancer,” American Cancer Society, 2023. https://www.cancer.org/cancer/lung-cancer/treating-non-small-cell/targeted-therapy.html
- “Lung Cancer Mutations and Targeted Therapy Options,” Memorial Sloan Kettering Cancer Center, 2021. https://www.mskcc.org/news/lung-cancer-mutations-and-targeted-therapy-options
- “Overcoming Resistance to Targeted Therapies in Lung Cancer,” Journal of Clinical Oncology, 2022. https://ascopubs.org/doi/full/10.1200/JCO.22.00471