New Hope for the Future of Lung Cancer Treatment

Adding Herceptin (HER2) to chemotherapy prolonged survival by five months in non-small cell lung cancer.

The successful results obtained with targeted therapies in cancer in recent years have made personalized treatment popular. Personalized treatment means treatment using targeted drugs that aim to destroy cancer cells according to the identified characteristics of the cancer. The goal is to identify the most effective treatment and ensure that it produces the best possible result for the patient. New targeted drugs developed on the basis of new biological findings in different cancer types are increasing our chances of success in cancer treatment every day.

The success achieved with new targeted drugs for lung cancer has further increased interest in this field. We can give two examples showing how genetic testing guides personalized treatment in adenocarcinoma, the most common subtype of lung cancer:

-Abnormal versions of the EGFR gene have been detected in %17 of patients with lung adenocarcinoma. Two drugs developed for these patient groups, Erlotinib and Afatinib, enter cancer cells and stop their growth mechanisms, providing substantial benefits to patients.

-In addition, an abnormal version of the gene known as ALK has been identified in %5-7 of these patient groups. A drug called Xalkori (crizotinib) was developed to target the abnormal ALK gene. In clinical trials, Xalkori provided substantial benefits to patients with lung adenocarcinoma in whom this genetic change was identified, enabling them to live longer.

A similar situation was observed before the 2000s in patients with breast cancer carrying the receptor (sensor) called Her2. Considerable success was achieved in this group using the targeted drug trastuzumab (Herceptin). Studies in recent years have also identified this receptor on the surface of tumors in a group of stomach cancers, and adding the targeted drug Herceptin to chemotherapy has produced more successful results.

This time, European researchers investigated groups carrying the HER2 receptor in their lung cancer cells and found positive findings in %5 of patients with non-small cell lung cancer.

In the clinical study, Herceptin was given in addition to chemotherapy to patients with non-small cell lung cancer carrying the Her2 receptor, a total of 65 patients. Adding Herceptin to treatment was found to extend patients' lives by another five months.

It is also notable that most participants with genetic mutations at diagnosis were women and that more than half had never smoked. Such genetic changes are prominent in patients who have never smoked and in women. In addition, the proportion of lung cancer patients who have never smoked and benefit from targeted treatments is remarkably high.

This study has created hope for a new treatment for approximately %5 of patients with advanced lung cancer. Extending patients' survival with HER2 treatment by 5 months is an important medical development. The positive findings of this study are still strong preliminary data. The level of evidence is not yet sufficient to routinely recommend this treatment to our patients. However, the positive results will motivate new studies in this field.