8 Things to Know About Targeted Therapies for Metastatic Non-Small Cell Lung Cancer

3. Targeted Therapies Are Less Likely Than Chemo to Cause Broad Side Effects

Because targeted therapies don’t kill healthy cells like chemotherapy does, they’re less likely to cause hair loss, nausea, and other side effects associated with chemo treatments, according to the ALA.

“These drugs have been quite well tolerated and tend to cause fewer and less-severe side effects than traditional chemotherapy,” says Garon.

4. But They Do Cause Some Side Effects

“As with any drug, there can be toxicities,” Garon notes. Those will depend on the type and dose of drug you take and your overall health, but the most common side effects are a skin rash and gastrointestinal problems.

Other side effects can include fatigue, flu-like symptoms, sore mouth, headache, loss of appetite, tingling in the hands and feet, taste changes, and sleep problems, according to the American Cancer Society (ACS).

Your healthcare team can help you manage any side effects you experience during treatment.

5. Targeted Drugs Aren’t for Everyone

According to Garon, not every genetic mutation currently has an FDA-approved targeted medication. “In addition to approved therapies, however, there are other mutations in non-small cell lung cancer for which there are drugs showing real promise in clinical trials.”

An article in JCO Oncology Practice notes that approximately 50 percent of patients with advanced NSCLC will be identified as having a DNA mutation that is primarily responsible for causing the cancer. That means the mutation can be identified by genomic testing and treated with targeted therapies.

As the available targets increase, so will the percentage of people with advanced NSCLC who are candidates for this type of treatment.

6. You Need to Be Tested to Know if Targeted Therapy Is an Option for You

The only way to know if you’re a candidate for targeted therapy is to undergo genetic testing (also called genomic testing, biomarker testing, or molecular profiling). This involves checking a sample of your cancerous tissue for gene or chromosomal changes known to occur in NSCLC. It’s often done at the same time as your initial biopsy, and the same tissue sample can even be used for both tests.

While genetic testing is considered the standard of care for metastatic NSCLC, it’s worth asking your doctor not only if you are being tested, but also exactly which mutations you are being tested for, Garon stresses.

“You want to make sure you’re being tested for mutations that have FDA-approved therapies, but also for mutations that may not have approved therapies yet, but do have drugs showing promise in clinical trials,” he says.

Comprehensive genetic testing will help you and your doctor determine all your possible treatment options.

7. Targeted Drugs Can Be Expensive

The cost of targeted therapy depends on the drug, but newer treatments tend to be more expensive than medicines that have been used for many years, according to the ACS Cancer Action Network’s “The Costs of Cancer” report.

Health insurance typically covers at least some of the cost, but each plan is different. Yours may cover targeted oral drugs under your prescription drug benefit, rather than your chemotherapy benefit, which may mean paying more out of pocket than you would for intravenous drugs given in a hospital or clinic.

Before you start treatment, find out how much your insurance company will pay for any targeted drug you’d take. If you need help covering the cost, ask your healthcare team about getting help from the drug company or applying for a copay or prescription drug assistance program.

8. You May Still Need Other Treatments

People with an EGFR or ALK mutation generally get targeted therapy as a first-line treatment. “Patients with other types of mutations sometimes go with chemotherapy-based approaches initially, then move to a targeted therapy,” says Garon.

Even if you start treatment with a targeted therapy alone, you may need to add other types of treatment at some point in your cancer journey. “Over time, the lung cancer cells may develop a way of continuing to grow, despite the drug, and the therapy is no longer effective,” Garon explains. How long that takes to happen can vary significantly, from several months to several years. When a targeted treatment is no longer effective, which is a common occurrence, according to one article, you may need to go on chemotherapy, immunotherapy, or a combination of the two.