If you've been diagnosed with non-small-cell lung cancer (NSCLC), it's natural to feel overwhelmed. But there's good news: Advances in non-small-cell lung cancer treatments are happening rapidly, offering early detection techniques to cutting-edge therapies.
Understanding these developments can provide new hope and empower you to make informed decisions about your care.
Early Detection: Catching Lung Cancer Sooner
Finding NSCLC early greatly improves the chances of successful treatment. New technologies and research have developed ways to spot lung cancer in its early stages. Here are a few of the latest.
Machine learning. Machine learning, a type of artificial intelligence, is revolutionizing how we detect lung cancer. By analyzing large amounts of data, machine learning can find patterns and predict outcomes with high accuracy.
One study found that machine learning was able to diagnose the two most common types of lung cancer with up to 97% accuracy – better than traditional methods. These algorithms look at your medical images, patient history, and genetic information to provide early and precise diagnoses, allowing timely treatment.
Advances in CT scans. Low-dose CT scans are now key in early lung cancer detection. The National Lung Screening Trial (NLST) found that low-dose CT scans can lower lung cancer death rates by 15%-20% compared to regular chest X-rays. Improvements in CT technology have made images clearer and reduced radiation exposure, making screening safer and more effective. New methods like helical CT offer detailed lung images, helping doctors find smaller tumors that older methods might miss.
Markers in blood and sputum. Scientists are working on better tests using your blood and sputum (mucus in the lungs) to catch lung cancer early. There are two main areas they’re focusing on:
- Blood tests. Researchers are studying blood samples to see if they can find tumor cells or specific molecules that indicate lung cancer. This could help diagnose the disease sooner.
- Sputum tests. Scientists are examining spit samples for unusual cells or molecules that might show someone needs more testing for lung cancer.
These advancements could lead to easier and earlier detection, making treatment for NSCLC more effective.
Surgical Advancements
Surgery is still a main treatment for early-stage NSCLC. New advancements have made surgeries safer and more effective.
Minimally invasive techniques, like video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgery, can help make recovery time easier and lower your risk of complications. Clinical trials have also shown that sometimes removing just part of a lung lobe works as well as removing the entire lobe, preserving more of your lung function and improving your quality of life.
Biomarker Tests
Biomarkers are essential in advancing NSCLC treatment, allowing for personalized therapy and better outcomes. By analyzing a tumor's genetic makeup, your doctors can decide which targeted therapies or immunotherapies will work best for you.
Biomarkers are biological molecules found in blood, other body fluids, or tissues that show the presence or state of a disease. In NSCLC, biomarkers can be genetic mutations, proteins, or other molecular signs that drive cancer growth or affect how the disease responds to treatment. The most common biomarkers tested for in NSCLC are changes in the genes KRAS, EGFR, ALK, ROS1, RET, MET, and BRAF.
Additionally, biomarkers can predict how you might respond to a treatment, track disease progression, and find why your cancer might be resistant to treatment. This personalized approach helps you get the most effective therapies, reducing unnecessary side effects, and improving overall outcomes.
New Immunotherapies
Immunotherapy has changed how we treat NSCLC by using your body’s immune system to fight cancer. These drugs help your body find and see cancer cells as harmful and stimulate a response to attack them.
Several new immunotherapies and combinations are making treatments more effective for patients having surgery for early-stage disease. Some of these include:
Atezolizumab and pembrolizumab. Atezolizumab (Tecentriq) and pembrolizumab (Keytruda) are immune checkpoint inhibitors. They block or "inhibit" communication between the PD-L1/PD-1 proteins, which prevents your immune system from attacking cancer cells. These drugs are approved for use after surgery and chemotherapy in certain early-stage NSCLC patients.
Nivolumab. Nivolumab (Opdivo) is another immune checkpoint inhibitor approved for use with chemotherapy before surgery (neoadjuvant therapy) for early-stage NSCLC and with chemo after surgery as adjuvant treatment (after primary treatment) for certain types of NSCLC. Clinical trials show that patients using nivolumab with chemotherapy live longer than those with chemotherapy alone. Nivolumab is also used in advanced stages of NSCLC, providing an extra defense against the disease.
Pembrolizumab and chemotherapy. Combining pembrolizumab with chemotherapy has shown great benefits in extending progression-free survival (PFS) for advanced NSCLC patients. This combo also is approved for use before and after surgery for early-stage NSCLC.
Durvalumab. Durvalumab (Imfinzi) is an immunotherapy drug approved for use with chemotherapy for adults with stage III NSCLC tumors that don’t improve with chemo and radiation. It helps prevent your cancer from coming back by strengthening your immune system to fight remaining cancer cells. Studies show that patients who were treated with durvalumab after chemoradiation had less chance of their tumor progressing, making it an important part of NSCLC treatment plans.
Other new immunotherapies are being studied, including new checkpoint inhibitors and combination therapies aimed at overcoming resistance and enhancing the immune response. Ongoing research continues to explore the full potential of immunotherapy in NSCLC treatment.
Targeted Therapies
Targeted therapies are used as adjuvant therapies – or after primary treatments – to reduce your chances of your cancer coming back. They focus on specific genetic mutations and molecular pathways that cause your cancer to grow. By precisely targeting these changes, these treatments offer more effective and personalized options for NSCLC patients.
Some targeted therapies used for NSCLC include:
ALK inhibitors. Anaplastic lymphoma kinase (ALK) inhibitors target genetic rearrangements in the ALK gene, found in about 5% of NSCLC cases. Newer ALK inhibitors, like alectinib (Alecensa) and brigatinib (Alunbrig), can cross the blood-brain barrier better, effectively treating brain metastases common in ALK-positive NSCLC. These drugs have shown longer progression-free survival and better overall outcomes than earlier ALK inhibitors like crizotinib (Xalkori).
EGFR inhibitors. Epidermal growth factor receptor (EGFR) mutations drive NSCLC in about 10%-15% of patients. Osimertinib (Tagrisso) is a top EGFR inhibitor approved for both advanced and early-stage NSCLC. It targets specific EGFR mutations effectively, offering better survival rates and less resistance than first-generation EGFR inhibitors. Osimertinib is now a standard treatment for patients with EGFR-mutated NSCLC.
ROS1 inhibitors. ROS1 gene changes occur in a small percentage of NSCLC patients. Targeted therapies like crizotinib (Xalkori), entrectinib (Rozlytrek), and the new repotrectinib (Augtyro) are effective in treating ROS1-positive NSCLC. These inhibitors block the ROS1 protein, stopping cancer cells from growing and spreading. Repotrectinib offers another option for patients who develop resistance to other ROS1 inhibitors.
BRAF inhibitors. BRAF mutations, especially the V600E mutation, are present in some NSCLC cases. Combination therapies using BRAF inhibitors like dabrafenib (Tafinlar) and MEK inhibitors like trametinib (Mekinist) have been effective in treating BRAF-mutated NSCLC. Encorafenib (Braftovi) combined with binimetinib (Mektovi) is another approved regimen, providing patients with this mutation targeted options that improve survival and reduce tumor growth.
RET inhibitors. RET gene alterations are found in about 1%-2% of NSCLC cases. Selpercatinib (Retevmo) and pralsetinib (Gavreto) are FDA-approved RET inhibitors that specifically target these genetic changes. These treatments help prevent cancer growth and spread, offering improved outcomes for patients with RET-positive NSCLC. They are effective even in cases with brain metastases.
MET inhibitors. MET gene mutations and amplifications happen in a small group of NSCLC patients with MET exon 14 skipping mutations (METex14). Capmatinib (Tabrecta) and tepotinib (Tepmetko) are MET inhibitors approved for treating the altered gene. These drugs block the MET protein, slowing tumor growth and enhancing survival rates. They provide targeted options for patients with specific MET-driven cancers.
KRAS inhibitors. KRAS protein mutations are among the most common genetic changes in NSCLC, especially the G12C variant. Sotorasib (Lumakras) and adagrasib (Krazati) are KRAS inhibitors that specifically target these mutations. By blocking the mutant KRAS protein, these treatments help slow tumor growth and improve survival rates for patients with KRAS-mutant NSCLC.
EGFR inhibitors. Epidermal growth factor receptor (EGFR) gene mutations are present in 10%-15% of NSCLC patients. This therapy targets and kills cancer cells with specific EGFR mutations. There are several EGFR inhibitors used to treat NSCLC. Osimertinib (Tagrisso) is a standard option approved for both advanced and early-stage NSCLC. In August 2024, the FDA approved lazertinib (Lazcluze), in combination with amivantamab-vmjw (Rybrevant), for the first-line treatment of NSCLC patients with an exon 19 deletion or L858R mutation in the EGFR gene.
HER2 inhibitors. HER2 (ERBB2) mutations are present in about 3% of NSCLC cases. Trastuzumab deruxtecan (Enhertu) is a HER2 inhibitor used to treat HER2-mutant NSCLC. By targeting the HER2 protein, this therapy helps reduce tumor size and progression. Trastuzumab deruxtecan is the first approved therapy for NSCLC with certain mutations in the HER2 gene.
TRK inhibitors. TRK gene fusions are rare in NSCLC but can drive cancer growth. Larotrectinib (Vitrakvi), entrectinib (Rozlytrek), and repotrectinib (Augtyro) are TRK inhibitors that target these genetic alterations. These drugs block the TRK proteins, effectively controlling tumor growth and spread. They provide valuable treatment options for patients with TRK fusion-positive NSCLC.
New Medications Approved by FDA
The FDA keeps approving new medications that improve NSCLC treatment, giving patients more effective and personalized options. Some of these include:
Repotrectinib. Repotrectinib (Augtyro) is a ROS1 inhibitor approved for advanced or metastatic NSCLC with ROS1 fusions. It works as both an initial and second-line treatment, giving flexibility for patients who have developed resistance to other ROS1-targeted therapies.
Amivantamab-vmjw plus lazertinib. Amivantamab-vmjw (Rybrevant) with the new EGFR inhibitor lazertinib (Lazcluze) is a major advancement in targeted therapy for NSCLC. This combo is especially effective for patients with specific EGFR mutations and has shown promising results in clinical trials, improving progression-free survival and overall response rates.
Pralsetinib (Gavreto). Pralsetinib (Gavreto) targets RET gene changes in NSCLC, offering a crucial treatment option for patients with metastatic RET-positive tumors. Pralsetinib is effective at shrinking tumors and delaying disease progression, enhancing the overall management of RET-driven NSCLC.
More FDA-approved medications to treat NSCLC continue to emerge and address various genetic mutations, offering patients personalized treatment options. These advances ensure that you can benefit from therapies tailored to your specific cancer profiles, improving your outcome and quality of life.
Emerging Therapies and the Future of Treatment
The future of NSCLC treatment looks bright, with ongoing research exploring new therapies and improving existing ones.
Liquid biopsies. Liquid biopsies can detect cancer-related genetic material in your blood. They’re noninvasive – you only have to give a few vials of blood – and your doctor can get your results much faster. That means you can start treatment sooner and your doctor can monitor your results and make adjustments faster, too.
CAR T-cell therapy. Chimeric antigen receptor T-cell (CAR T) therapy, successful in blood cancers, is being studied for solid tumors like NSCLC. By modifying a patient's own T cells to target specific cancer antigens, CAR-T therapy aims to boost their immune system's ability to kill their cancer cells. While still in early research stages for NSCLC, initial studies are promising and suggest potential future uses.
TIL therapy. Scientists have discovered TIL therapy to be a promising new type of immunotherapy for patients with advanced NSCLC who had no other treatment options. TIL therapy works by taking special immune cells called tumor-infiltrating lymphocytes (TILs) from your tumor, growing them in the lab until there are many of them, and then infusing them back into your body. These enhanced cells help your immune system recognize and attack cancer cells, offering a new way to treat solid tumors like NSCLC.
What Can You Do?
Advances in treating non-small-cell lung cancer are changing what was once a scary diagnosis into a condition with more hopeful outcomes. Early detection methods are getting better, making it possible to catch cancer sooner when it’s more treatable. Cutting-edge treatments like immunotherapies and targeted therapies offer more effective and personalized options than ever before.
Here’s what you can do to stay updated on the latest developments in NSCLC treatment:
- Stay informed. Talk to your doctor and care team about new therapies that are emerging to see if any are right for you.
- Ask about biomarker testing. Ensure that your treatment plan is tailored to your cancer's specific characteristics.
- Discuss all options. Work closely with your health care team to explore all available treatments, including new medications and combinations.
- Consider clinical trials. Participating in research studies can give you access to the latest therapies and contribute to advancements that help others.
Remember, your health care team is there to support you every step of the way, helping you navigate the many options available to you.
Show Sources
Photo Credit: Cultura RF/Andrew Brookes/Medical Images
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