As of: February 5, 2024, 1:07 p.m
By: Natalie Hull-Deichsel
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A cancer diagnosis is always a shock.
It is all the more important that patients are fully aware of the treatment options, as an oncologist explains in an interview.
Years ago, if a patient was diagnosed with lung cancer, the first choice of treatment was in most cases chemotherapy and radiation therapy.
It is now known that certain forms of cancer can be traced back to genetic changes in tumor cells, which make more targeted therapy possible for an increased chance of survival.
Diagnostics at the cellular level plays an important role.
They can be used to decipher whether genetic changes such as the so-called ALK mutation in non-small cell lung cancer - which particularly affects younger patients - ultimately trigger the development and growth of the tumor.
New medications and active ingredients against this type of tumor cell are highly effective and relatively well tolerated.
So far, they have been effective, often for years, particularly in patients in whom the cancer has already spread, i.e. metastasized.
Study results presented at the
European Cancer Congress ESMO
also show that these targeted therapies are effective even in the early stages of the disease and drastically reduce the risk of relapse.
What represents a particular added value: the treatment does not require chemotherapy.
Dr.
med.
Jan Stratmann, specialist in internal medicine and oncologist at the Johann Wolfgang Goethe University Hospital in Frankfurt am Main, explains the possibilities of targeted cancer therapy, not just for lung cancer, in an exclusive conversation with Ippen.Media.
Targeted cancer therapy: For which patients is it an option?
Dr.
med.
Jan Stratmann, specialist in internal medicine, hemostaseology, palliative medicine and oncology at the Johann Wolfgang Goethe University Hospital in Frankfurt am Main © Jan Stratmann/nNGM
Basically, for advanced lung cancer, as for some other metastatic tumor diseases, there are three treatment options:
Chemotherapy, which uses cell toxins to destroy tumor cells
Immunotherapy, which activates your own immune system and defense cells
Targeted cancer therapy in which signaling pathways of the modified genes are inhibited
Targeted therapy is based on the idea that specific genetic changes are responsible for the development of cancer.
These can be found, for example, in gene sections that are responsible for cell growth.
If such a signaling pathway is then permanently active due to the mutation, it causes the uncontrolled growth of cells, the typical feature of cancer.
Dr.
med.
Jan Stratmann, specialist in internal medicine and oncology
Patients who have so-called driver mutations - that is, the cancer is due to genetic changes - could fundamentally benefit from targeted therapy tailored to the mutation.
The pioneer of this type of tumor treatment was and is chronic myeloid leukemia, whose cancer therapy concept used targeted substances.
“As a result, we now treat many tumor diseases such as breast cancer, bile duct cancer, brain tumors, salivary gland tumors, stomach cancer, colon cancer, prostate cancer and lung cancer with targeted substances,” explains Dr.
Stratman.
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If it is proven that a tumor is due to a genetic change, the tumor can be treated and combated precisely with the help of a special medication.
Examples of genes whose alterations can trigger cancer are ALK, EGFR, ROS1 or BRAF.
What characterizes the active ingredients of targeted therapy?
In the metastatic, i.e. advanced, stage of the disease, it can be seen that targeted therapy works better compared to chemotherapy and immunotherapy, and patients also tolerate it better.
In addition, most targeted substances also act in the central nervous system, which represents a decisive advantage over chemotherapy, which usually has little effect there.
Especially if metastases are already found in the brain, the spread can be delayed and the patient's survival time extended.
According to the German Cancer Society (DGK),
for example, an ALK inhibitor used to treat lung cancer has
exactly this effect.
Lung cancer can spread to other parts of the body through various routes, such as lymph nodes, liver, brain or bones.
Therefore, patients with cancer should always be examined for possible genetic changes in the tumor and informed about the chances of targeted therapy.
The positive: The genetic testing of cancer cells is usually covered by health insurance companies.
Targeted cancer therapy: What are the side effects?
As with any cancer therapy, targeted treatment can be accompanied by undesirable side effects.
However, the active ingredients are very precisely targeted for use against tumor cells, so side effects are usually fewer and less severe compared to chemotherapy.
The possible side effects of targeted cancer therapy include tiredness, fatigue, body aches, diarrhea, skin redness, itching and high blood pressure.
Genetic lung cancer: Which age groups are particularly affected?
The range of patients with a cancer diagnosis is wide and extends from young years to old age.
Up to 60 percent of women are affected by lung cancer caused by a genetic mutation.
However, how likely is it that the ALK gene, for example, causes cancer through its alteration?
“The risk increases consistently with younger age and is highest in those under 40, at up to 20 percent,” says Dr.
Stratmann from experience.
Two types of tumors in lung cancer
Based on their characteristic features, tumors and carcinomas are divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).
The majority of lung cancer cases, namely around 80 percent, belong to the NSCLC carcinomas, of which there are various subtypes and variants such as the ALK-positive form.
Genetic changes in the cells, especially in so-called oncogenes, are responsible for the development of cancer.
ALK-positive lung cancer occurs in approximately five percent of all patients with non-small cell lung cancer.
This article only contains general information on the respective health topic and is therefore not intended for self-diagnosis, treatment or medication. It in no way replaces a visit to the doctor. Our editorial team is not allowed to answer individual questions about medical conditions.