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Non-Small-Cell Lung Cancer (cont.)

What Targeted Therapy Drugs Treat NSCLC?

Examples of targeted therapy agents that are currently used to treat NSCLC include the following:

  • Gefitinib (Iressa), erlotinib (Tarceva), and Afatinib (Gilotrif): These are new targeted drugs used to treat advanced NSCLC that is resistant to more conventional chemotherapy agents. These drugs are referred to as tyrosine kinase inhibitors. They inhibit the activity of a substance called epidermal growth factor receptor tyrosine kinase, which is located on the surface of cells and is needed for growth.
  • Crizotinib (Xalkori) and ceritinib (Zykadia) are drugs that are anaplastic lymphoma kinase tyrosine kinase inhibitors; they are used to treat tumors that harbor the (ALK) fusion oncogene (ALK-positive) NSCLC.

What Immunotherapy Medications Treat NSCLC?

Examples of immunotherapy agents that are currently used to treat NSCLC include the following:

  • Nivolumab (Opdivo) and pembrolizumab (Keytruda): These drugs are examples of immune checkpoint inhibitors. These treatments work by stimulating the immune system. These drugs target the immune checkpoint known as PD-1.
  • Bevacizumab (Avastin) and ramucirumab (Cyramza) are monoclonal antibody drugs that preventing tumors from growing new blood vessels, a process called angiogenesis.
  • Ipilimumab (Yervoy) is a checkpoint inhibitor that targets a checkpoint known as CTLA-4

When Is Surgery Appropriate for Non-Small-Cell Lung Cancer?

Surgical removal of the tumor provides the best chance of long-term, disease-free survival and the possibility of a cure. In stages I and II NSCLC, removal of the tumor by surgery is almost always possible unless the person is ineligible for surgery because of other medical conditions or complications of the tumor. (These patients usually receive radiation therapy.) Generally, only some stage III cancers are operable. People with most stage III or IV tumors are generally not candidates for surgery.

Less than half of people with NSCLC have operable tumors. Approximately half of people who undergo surgery have a relapse after surgery.

Before a patient can undergo surgery for lung cancer, pulmonary function tests are carried out to make sure the lung function is sufficient.

The standard operations for lung cancer include lobectomy (removal of one lobe of the lung) or pneumonectomy (removal of the whole lung). Attempts to remove a smaller part of the lung (wedge resections) carry a higher risk of recurrence and poor outcome.

Like all operations, these procedures have benefits and risks. All operations carry a risk of complications, both from the operation itself and from the anesthesia. The surgeon discusses these benefits and risks with the patient. Together, they decide whether the patient is a candidate for surgery.

Medically Reviewed by a Doctor on 11/21/2017

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