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Targeted Therapy

Targeted therapy for advanced non-small cell lung cancer (NSCLC)

Targeted therapy drugs are most often used for patients with advanced NSCLC, either along with chemotherapy or by themselves, to stop cancer cells from growing and spreading. They are called "targeted" due to the nature of the drugs that target specific characteristics of the cancer.

Tumour blood vessel growth (angiogenesis)

Image of human blood vessels

For tumours to grow, they need to form new blood vessels to keep them nourished. This process is called angiogenesis. This new blood vessel growth in advanced non-small cell lung cancer (NSCLC) can be blocked by angiogenesis inhibitors:

Gene alterations (mutations)

Targeted therapy for advanced non-small cell lung cancer (NSCLC) also works by disrupting the mutation of specific types of genes including EGFR, ALK and BRAF.

Cells with EGFR alterations (mutations)

Some NSCLC patients harbour sensitising mutations in EGFR (epidermal growth factor receptor), which cause the cancer cells to grow faster. These mutations are more common in women and people who never smoked. Drugs called EGFR inhibitors target mutant EGFR proteins to block the growth signal.

Cells with ALK alterations (mutations)

About 5% of NSCLC patients have a rearrangement in a gene called ALK. This change is most often seen in non-smokers (or light smokers) who have adenocarcinoma. The ALK gene rearrangement produces an abnormal ALK protein that causes the cells to grow and spread. Drugs called ALK inhibitors target abnormal ALK proteins to block the growth signal.

Cells with BRAF alterations (mutations)

Cells with BRAF gene changes make an altered BRAF protein that helps them grow. Some drugs target this and related proteins:

These drugs can be used together to treat metastatic NSCLC if it has a certain type of BRAF gene mutation.

References:
American Cancer Society: Targeted Therapy Drugs for Non-Small Cell Lung Cancer.
Retrieved Nov 2017 from https://www.cancer.org/cancer/non-small-cell-lung-cancer/treating/targeted-therapies.html