You’re on Targeted Therapy? Is That the Same as Immunotherapy?

Last week, I went to a checkup appointment for my 85 year old mother and ended up discussing lung cancer with her primary care doctor. When I told him I was a stage IV lung cancer survivor, he started telling me about this wonderful new treatment “they have” called immunotherapy that has much fewer side effects than traditional chemotherapy. I explained to him that immunotherapy isn’t usually recommended for the type of cancer I have because of my EGFR mutation and told him I was on targeted therapy. He said “yes, that’s what I meant” and quickly changed the subject. His response immediately told me that he wasn’t clear on the difference between targeted therapy and immunotherapy.

He’s most definitely not the only one. I’ve come across many fellow patients, caregivers, and medical professionals who are confused about this as well. Since immunotherapy has gotten so much press in recent years, it’s become a more commonly known term, even though many don’t really understand fully what it means.

So, What’s the Difference?

I’m going to attempt to explain the differences between targeted therapy and immunotherapy. Keep in mind that my background is in communications and management and I have no medical training whatsoever! As a result, please be understanding if I’m a little off on a detail. With that warning out of the way, here I go!

Targeted therapy uses drugs to attack specific cancer cells. In lung cancer, testing can be done to see if a patient has changes in a variety of genes — some of these are EGFR, ALK, ROS1, BRAF, and MET. This testing (often called molecular testing, mutation testing or even next generation sequencing) is usually done through either a lung tissue biopsy or a blood biopsy. If a gene change (also known as a mutation) is discovered, a patient can be prescribed a targeted therapy drug that will work specifically to inhibit that mutation and hopefully shrink the cancer. These targeted therapy medications tend to be in the form of pills, taken orally.

In contrast, immunotherapy drugs don’t attack cancer cells directly; instead, they stimulate the patient’s own immune system to recognize cancer cells as foreign bodies and attack these cancer cells. In lung cancer, there are several immunotherapy treatments already FDA approved and numerous other treatments, including combination immunotherapy treatments, in trials. Often, a biopsy will be done to check the level of a patient’s PD-L1 protein prior to treating with a Immunotherapy medication. Most immunotherapy medications are given as intravenous infusions.

Learning the Lung Cancer Lingo

When a patient is diagnosed with lung cancer, it’s like entering a foreign country where you need to learn a new language. Understanding the differences between targeted therapy and immunotherapy is just one part of this new language; there are many others. When I was first diagnosed in late 2013, I totally didn’t speak “lung cancer” and had to pick up all my information and knowledge along the way.

In order to get the best possible care, I believe it’s crucially important to be your own advocate or have an involved caregiver as your advocate. I would highly advise any new lung cancer patient to ask as many questions as you need in order to understand your own tests and treatment.

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