Targeted therapy for Non small cell lung cancer

1. TARGETED THERAPY FOR NON-SMALL CELL LUNG CANCER In recent years, the advancement of targeted drug therapy for lung cancer has caused a rapid decline in the death rate of patients with non-small cell lung cancer. Therefore, drugs are also being developed accordingly to meet the requirements. It must be mentioned that their functions differ profoundly from that of standard chemotherapy drugs. Targeted drugs for curbing the growth of tumor blood vessels The tumors are nourished by blood vessels, which also helps them grow by the process of angiogenesis. Some of the commonly prescribed angiogenesis inhibitors are: •Bevacizumab- Useful for conducting targeted therapy in advanced NSCLC patients, this monoclonal antibody aims at the vascular endothelial growth factor (VEGF), which helps in the formation of new blood vessels, to shrink the tumors and prevent them from growing. •Ramucirumab- It is also a monoclonal antibody that helps to target the VEGF receptors and cease the formation of new blood vessels. It is usually prescribed in combination with chemotherapy. List of targeted drug therapy inhibitors used in NSCLC

2. 1. EGFR Receptors The EGFR proteins that grow on the surface of normal cells help them divide and grow within the body. The non-small cell lung cancer cells have a high amount of EGFR, which induces rapid growth. EGFR inhibitors are drugs that block the signal from the proteins that help them to grow. To name a few, there are: •Erlotinib •Afatinib •Gefitinib •Dacomitinib Erlotinib 150mg, Afatinib 40mg, and Gefitinib 250mg are effective for conducting therapies in patients with advanced NSCLC who have a particular mutation in the EGFR gene. All of these medications are consumed in pill form. 2. EGFR inhibitors and T790M mutation Typically, EGFR inhibitors are useful for suppressing the growth of cancer cells temporarily because they form a different mutation like T790M in most cases. Drugs like Osimertinib are useful to target the cells with this specific mutation. 3. Squamous cell NSCLC & EGFR inhibitors The monoclonal antibody named Necitumumab is used to target the EGFR in patients diagnosed with advanced squamous cell NSCLC. 4. ALK gene changes Often diagnosed in non-smokers with NSCLC, the gene rearrangement known as ALK is responsible for producing an abnormal protein that causes the cells to grow and spread in large numbers. There are different drugs that can target the abnormal ALK proteins like Crizotinib, Ceritinib, Alectinib, Lorlatinib, etc. They help the tumor to shrink and can be used in place of chemotherapy. 5. ROS1 gene changes Approximately 1-2% of the NSCLC cases have the gene rearrangement, also known as ROS1. In this case, the tumors are negative for ALK, KRAS, and EGFR mutations. The drugs that help to target the ROS1 proteins to shrink the tumor or curb the further growth of cancer cells are Ceritinib, Entrectinib, etc. 6. BRAF inhibitors The NSCLC cells that have mutations in the BRAF gene can benefit from the following targeted therapy drugs: •Dabrafenib (BRAF inhibitor)

3. •Trametinib (MEK inhibitor) 7. RET gene changes Selpercatinib is a type of RET inhibitor that specifically targets the RET protein to treat metastatic NSCLC. 8. MET gene changes The abnormal MET protein is targeted by MET inhibitors like Capmatinib to stop the growth and spread of cancer cells. 9. NTRK gene changes Larotrectinib and Entrectinib are two of the drugs that are useful in disabling the action of the proteins made by the NTRK genes. Conclusion Note that before prescribing the drugs, the doctor will conduct medical examinations on the tumor to determine the type of gene mutation it features. Source: https://diseaseandmedications.weebly.com/blog/targeted- therapy-for-non-small-cell-lung-cancer