There are a lot of different drugs used to treat lung cancer. They work by shrinking tumors or slowing their growth. The right medicines for you will depend on many factors. These include your cancer’s type, stage, and response to previous drugs. Your doctor will also look at test results and your health history to help decide which drugs might help you.1
There are several types (classes) of drugs used to treat lung cancer. They work in different ways to affect cancer cells. They include:1
Many people with lung cancer receive multiple drugs that work in different ways. Medications may also be part of a treatment plan that includes surgery or radiation.1
How do drugs work to treat lung cancer?
Chemotherapy drugs treat lung cancer by interfering with cell growth. They typically block DNA replication and cell division. This kills cells that divide fast, such as cancer cells. But chemotherapies can also kill healthy cells.2,3
Targeted therapies block or slow the growth and spread of cancer by interfering with specific areas of cancer cells that are involved in the cancer cell’s growth processes, or by focusing on specific features that are unique to cancer cells. Cancer cells often have changes (mutations) to their DNA that help them grow. If your doctor can identify the specific changes happening in your cancer, targeted therapies may be able to help treat it.4
Immunotherapies help your immune system destroy cancer cells. In lung cancer treatment, they block proteins that can protect cancer cells from immune cells. These proteins are called immune “checkpoints.” Blocking them boosts immune system activity against cancer cells.5,6
Examples
Many medicines may be used to treat certain forms of lung cancer.
Chemotherapies are generally classified by how they block cell division. Examples include:2,3,7
- Alkylating agents, such as Paraplatin® (carboplatin)
- Antimetabolites, such as Alimta® (pemetrexed)
- Mitotic inhibitors, such as Taxol® (paclitaxel)
- Topoisomerase inhibitors, such as Hycamtin® (topotecan)
- Anti-tumor antibiotics, such as Adriamycin® (doxorubicin)
Targeted therapies are generally classified by the protein they target. Some target more than 1 protein. Examples of these drugs include:4
- EGFR inhibitors, such as Gilotrif® (afatinib)
- ALK inhibitors, such as Alecensa® (alectinib)
- ROS1 inhibitors, such as Xalkori® (crizotinib)
- NTRK inhibitors, such as Rozlytrek® (entrectinib)
- MET inhibitors, such as Tabrecta® (capmatinib)
- RET inhibitors, such as Retevmo® (selpercatinib)
- KRAS inhibitors, such as Lumakras® (sotorasib)
Immunotherapy drugs are generally classified by the immune checkpoint they block. Examples include:5,6
- PD-1 blockers, such as Opdivo® (nivolumab)
- PD-L1 blockers, such as Tecentriq® (atezolizumab)
- CTLA-4 blockers, such as Yervoy® (ipilimumab)
Treatment for small cell lung cancer often includes chemotherapy drugs. They may be given:3,6
- Alone
- With PD-L1 blockers
- With radiation therapy
Treatment for non-small cell lung cancer often includes immunotherapies. They may be used with chemotherapy drugs. Chemotherapy drugs can also be used alone. Treatment may also involve targeted therapies alone or with other therapies.2,4,5
What are the possible side effects?
Side effects can vary depending on the specific medicine you are taking. Chemotherapy drugs, targeted therapies, and immunotherapies can all cause side effects, and in some cases, these can be severe.2-6
Common side effects of certain lung cancer drugs can include:2-6
- Hair loss
- Sores in your mouth, low appetite, nausea, vomiting, diarrhea, constipation, and weight changes
- Cough
- Increased risk of infections
- Easy bruising, easy bleeding, skin problems, and pain in your joints, muscles, or bones
- Fatigue
- High blood pressure
Serious side effects are possible. Many medicines have boxed warnings, the strictest warning from the US Food and Drug Administration. The specific warning depends on the drug. Many chemotherapies have this warning because of the risk of very low blood cell counts. Some targeted therapies have this warning because of the risk of heart or lung problems.8-12
Immunotherapies can cause serious autoimmune reactions. This happens when immune cells attack normal healthy cells. Some immunotherapies can also cause infusion reactions. These are similar to allergic reactions.5,6
These are not all the possible side effects of lung cancer medications. Talk to your doctor about what to expect with your specific lung cancer treatment. You also should call your doctor if you have any changes that concern you while receiving lung cancer treatment.
Other things to know
Take lung cancer medicines as your doctor prescribes. Your doctor will talk to you about your treatment schedule.
Your doctor will also perform tests during treatment. This can help them see how well medications are working. Many drugs can stop working over time. This may be because the cancer becomes resistant to the drug. If this happens, your doctor may recommend other treatments.1
Before beginning treatment for lung cancer, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.