Treatment Options

These treatments are used for both non-small cell and small cell lung cancer patients.

Medication given through an IV directly into the bloodstream reaches cancer cells throughout the body. This is called systemic therapy.

Medication applied directly to the cancer or kept in a single part of the body is called regional therapy.

The types of medications used for lung cancer include:

• Chemotherapy
• Targeted therapy
• Immunotherapy

Chemotherapy for Lung Cancer

Chemotherapy uses drugs to stop cancer cell growth by killing the cells or by stopping them from dividing. The way the chemotherapy is given depends upon the type and stage of the cancer being treated.

Targeted Therapy for Non-Small Cell Lung Cancer

Targeted therapy for lung cancer has recently become available for advanced, metastatic, or recurrent non-small cell lung cancer (NSCLC). There is some use of a few targeted therapies for small cell lung cancer at this time.

Targeted therapies focus on specific genetic changes within cancer cells. Unlike chemotherapy, targeted therapy attacks cancer at the molecular level, often with fewer side effects on normal cells.

Before starting a targeted therapy, your oncologist performs biomarker testing (molecular or genomic testing) to identify specific genetic mutations in the tumor and determine whether targeted drugs may be effective. Testing can be done on biopsy tissue or, in some cases, through a liquid biopsy, which analyzes tumor DNA in the bloodstream.

EGFR, ALK, KRAS, ROS1, RET, BRAF, MET, HER2, and NTRK mutations are common biomarkers that can guide NSCLC treatment.

If a genetic mutation is found, your lung cancer specialist may recommend monoclonal antibodies or tyrosine kinase inhibitors (TKIs)—drugs designed to block cancer growth at its source.

Types of Targeted Therapies:

• Angiogenesis Inhibitors – Block blood vessels from forming, which is needed for tumor growth.
• KRAS Inhibitors – Target KRAS gene mutations, particularly KRAS G12C.
• EGFR Inhibitors – Block signals promoting cancer cell growth in EGFR-mutated NSCLC.
• ALK Inhibitors – Treat ALK gene rearrangements, common in younger non-smokers.
• ROS1 Inhibitors – Target ROS1 gene rearrangements.
• BRAF Inhibitors – Block abnormal BRAF proteins in NSCLC.
• RET Inhibitors – Target RET gene rearrangements in metastatic NSCLC.
• MET Inhibitors – Block MET protein in NSCLC with MET exon 14 skipping mutations.
• HER2-Directed Drugs – Treat HER2-mutated NSCLC via IV infusions.
• TRK Inhibitors – Target rare NTRK gene fusions.

These targeted therapies provide personalized treatment options based on genetic mutations, which have proven helpful in improving outcomes for NSCLC patients. At HOA, we incorporate comprehensive biomarker testing into every NSCLC diagnosis, ensuring patients receive the most effective, personalized treatments.

If no biomarkers are detected, other treatment approaches, such as chemotherapy, immunotherapy, or radiation therapy, may be more appropriate.

Immunotherapy for Lung Cancer

Immunotherapy drugs help the body’s immune system kill cancer cells. There are several classes of immunotherapy drugs that work in different ways. For patients with lung cancer, oncologists test tumor cells for PD-L1 to see “if” and “how much” of this protein the tumor is producing. This will guide decisions about whether the patient would benefit from certain immunotherapy drugs.

The immunotherapies currently available to treat lung cancer are checkpoint inhibitors. Checkpoint inhibitors block proteins that prevent the immune system from attacking cancer and are administered via IV infusions every few weeks.

PD-1 and PD-L1 Inhibitors

PD-1 and PD-L1 inhibitors boost immune responses against cancer, slowing tumor growth. For advanced NSCLC, these drugs may be used alone, with chemotherapy, or with CTLA-4 inhibitors. They can also be given before or after surgery in early-stage lung cancer.

PD-L1 inhibitors can be used alongside chemotherapy for advanced SCLC and may continue as maintenance therapy. It may also be an option after chemotherapy and radiation in early-stage SCLC.

Bispecific T-cell Engager (BiTE) for SCLC

Tarlatamab is an immunotherapy that binds to immune cells and cancer cells, directing the immune system to attack the cancer. It is often used for extensive-stage SCLC that has not responded to previous treatments.

Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. The way radiation therapy is given to lung cancer patients depends on the type and stage of the cancer being treated.

Types of Radiation Therapy

• External Radiation Therapy – A machine outside the body delivers targeted radiation to the cancer.
• Internal Radiation Therapy (Brachytherapy) – A radioactive substance sealed in needles, seeds, wires, or catheters is placed directly into or near the cancer. This is often done through a bronchoscope, a procedure called endobronchial brachytherapy, but may also be performed during surgery.
• Prophylactic Cranial Irradiation (PCI) – Radiation therapy to the brain to reduce the risk of lung cancer spreading there.

CyberKnife®: The Most Advanced Radiation Treatment for Lung Cancer

Hematology-Oncology Associates of CNY is the only cancer center in Central New York offering CyberKnife®, a groundbreaking, non-invasive radiation therapy for lung cancer. CyberKnife® delivers stereotactic body radiation therapy (SBRT) with robotic precision, targeting only the cancerous tissue while sparing healthy tissue. This approach allows for higher success rates, fewer treatments, and minimal side effects compared to conventional radiation.

Key Benefits of CyberKnife®:

• Non-invasive alternative to surgery – Ideal for patients who are not surgical candidates or prefer a less invasive option.
• Exceptional accuracy – Targets tumors with sub-millimeter precision, reducing damage to surrounding healthy tissue.
• Fewer treatments, better results – CyberKnife® can often be completed in just 1 to 5 sessions, compared to weeks of traditional radiation.
• Highly effective – 90% control rates and much less toxicities because of reduced radiation to surrounding healthy tissue.
• Comfort and ease – Patients remain fully clothed and do not need to hold their breath or worry about small movements during treatment.

HOA has been at the forefront of CyberKnife® technology since 2007 and continues to provide the latest treatment technologies, ensuring patients receive the highest level of cancer care close to home.

Learn more about CyberKnife®