Save the lives of lung cancer patients with a new generation of targeted drugs

Video content is professionally consulted by MSc, BS, Quach Thanh Dung, Radiation Oncology Center - Vinmec Times City International Hospital

Over the past 30 years, research on genetic profiles in cancer pathology, especially late-stage lung cancer, has really "exploded". One of the achievements is the detection of important gene mutations that affect cancer, known as "Driver mutations". Since then, scientists have researched the latest form of lung cancer drug that inhibits the activity of these gene mutations, preventing cancer cells from growing, promoting the process of spontaneous death. nature of cells.
Treatment using the latest lung cancer drugs with the above mechanism of action, targeting molecular targets is called targeted therapy.
Drugs that target EGFR are EGFR tyrosine kinase inhibitors (EGFR-TKI), which help prevent tumor growth. Currently, EGFR-TKI has 3 generations being used for patients with advanced stage non-small cell lung cancer or terminal lung cancer, specifically as follows:
1st generation drugs include: Erlotinib and Gefitinib. Both drugs have similar therapeutic effect, helping to improve quality of life, increase tumor response rate, prolong disease progression-free time by 5-6 months compared to chemotherapy. According to the IPASS study, with more than 1200 non-small cell lung cancer patients, cases with EGFR sensitive gene mutations treated with Gefitinib brought some benefits such as: 70% tumor reduction, 50% reduced risk of disease progression, and 22% reduced risk of death compared with chemotherapy. The advantage of this group of drugs is safety, few side effects, mainly skin rash if erlotinib is used or liver enzymes increase if gefitinib is used. 2nd generation drugs include Afatinib and Dacomitinib. The ability to inhibit the activity of EGFR mutations in a sustainable, irreversible way is the advantage of this group of drugs. According to the study, both drugs, especially dacomitinib, help prolong disease progression better than erlotinib and gefitinib. 3rd generation drugs include osimertinib. Similar to the 2nd generation drugs, osimertinib also has the ability to inhibit the activity of EGFR mutations in a sustainable, irreversible way. In particular, it can also inhibit mutations in the T790M gene. This is a type of gene mutation that increases the likelihood of treatment failure. It occurs in about 50%-60% of cases of non-small cell lung cancer patients treated with drugs targeting 1st or 2nd generation EGFR after 9-12 months. It is important to note that not all cases of terminal lung cancer can be treated with drugs that target EGFR. Only when the tumor cell sample or the patient's blood sample is tested for the presence of EGFR mutations, the use of this class of drugs is effective.


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