Lung cancer treatment has evolved with targeted therapies and immunotherapies. Learn how genomic analysis and precision medicine are improving survival rates for lung cancer patients.
According to Globocan 2020, lung cancer is the second most common cancer by incidence, affecting 2.2 million people (11.4%). It is the most common cause of cancer-related deaths, affecting 1.7 million worldwide (18%). In India, it has an incidence of 72,510 and causes 66,279 deaths every year.
Lung Cancer Treatment Modalities
Lung cancers can be treated with:
- Surgery
- Chemotherapy
- Radiation therapy
- Targeted therapy
- Immunotherapy
- Or a combination of these treatments
Genomic Analysis and Targeted Therapy
Genomic analysis of tumor tissue has revolutionized lung cancer treatment. By identifying specific gene mutations, doctors can select targeted therapies that block the signals driving cancer growth.
Common actionable mutations include:
- EGFR – treated with Osimertinib, Gefitinib, Erlotinib
- ALK – treated with Crizotinib, Alectinib, Brigatinib
- ROS1 – treated with Crizotinib, Entrectinib
- BRAF V600E – treated with Dabrafenib + Trametinib
- RET – treated with Selpercatinib, Pralsetinib
- MET exon 14 skipping – treated with Capmatinib, Tepotinib
- NTRK – treated with Larotrectinib, Entrectinib
These oral drugs often have fewer side effects than chemotherapy and offer better progression-free survival.
Role of Immunotherapy
Immunotherapy works by releasing the brakes on the immune system so it can attack cancer cells. It's particularly effective in patients whose tumors express high levels of PD-L1 or have a high tumor mutational burden (TMB).
Common immunotherapies include:
- Pembrolizumab (Keytruda)
- Nivolumab (Opdivo)
- Atezolizumab (Tecentriq)
- Durvalumab (Imfinzi)
Used alone or in combination with chemotherapy, immunotherapy has improved overall survival in advanced non-small cell lung cancer (NSCLC).
Who Benefits from Immunotherapy?
- Patients with metastatic NSCLC and high PD-L1 expression (≥50%)
- Patients with recurrent disease after prior therapy
- Patients with cancer recurrence in the chest after previous treatment whose cancer has not spread outside the chest
Systemic Treatment for Lung Cancer
Systemic therapies circulate throughout the body and are essential for treating cancer that has spread. The choice depends on:
- Cancer type (NSCLC vs SCLC)
- Stage of disease
- Molecular profile (gene mutations)
- Patient’s overall health
Targeted therapy and immunotherapy have resulted in better treatment responses than standard chemotherapy for certain subtypes of lung cancer.
The Era of Personalized Medicine
Today, lung cancer is no longer treated as a single disease. Every patient’s tumor is unique, and treatment is increasingly tailored based on molecular profiling.
Comprehensive biomarker testing at diagnosis is now considered standard of care to identify the best treatment option.
Future Directions
Ongoing research focuses on:
- Newer generation targeted drugs to overcome resistance
- Combination immunotherapies
- Early detection through liquid biopsy (circulating tumor DNA)
- AI-driven imaging analysis for early diagnosis
With these advancements, lung cancer is gradually shifting from a fatal diagnosis to a manageable chronic condition for many patients.