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Consumer’s Guide to Targeted Therapies for EGFR+ Non-Small-Cell Lung Cancer

Tailored, cutting-edge treatments can help improve your quality of life.

Medically Reviewed

A pproximately 541,000 people in the United States have lung cancer, according to the American Lung Association. The most common type, non-small-cell lung cancer (NSCLC), accounts for 80 to 85 percent of cases, according to the American Cancer Society.

About one in four people with NSCLC have tumor DNA with a mutation in the epidermal growth factor receptor (EGFR) gene, according to an analysis of data from more than 150 studies published in August 2015 by the American Journal of Cancer Research. More than 70 different EGFR mutations have been identified, and specific drugs — known as targeted therapies — have been approved to treat many of them.

Before you ask your doctor about the best treatment for EGFR-positive NSCLC, do your homework! It’s important to be an active participant in your care, and a big part of that is educating yourself about your options for genetic testing and targeted treatment in order to work with your oncologist to make informed treatment decisions.

We’re here to help: Here’s what you should know about EGFR-positive NSCLC and how targeted treatments work.

The Role of Genetic Testing in Treatment Selection

When you’re diagnosed with lung cancer, the next step will likely be to have a type of genetic test called next-generation sequencing, explains Keith Eaton, MD, PhD, an oncologist at Seattle Cancer Care Alliance and a professor of oncology at the University of Washington School of Medicine. This helps doctors know if the cancer tumors have mutations or alterations that are known to drive cancer growths, he says.

Among the many possible mutations is one on the epidermal growth factor receptor (EGFR) gene. If you test positive for that, it means you have EGFR-positive NSCLC.

EGFR is a protein found on the surface of both healthy and cancer cells. When the protein is damaged because of a genetic mutation, it doesn’t perform the way it should, causing rapid cell growth and helping the cancer spread.

Although there are more than 70 different EGFR mutations in NSCLC, most are caused by alterations in exon 19 and exon 21, with exon 18 and exon 20 mutations being less common and more difficult to treat.

Once genetic testing has determined that you have an EGFR mutation, and identified the specific type, your oncologist may prescribe a targeted drug therapy to help slow the growth of cancer cells. Although these drugs won’t cure your lung cancer, they can help slow progression of the disease and delay the onset of serious symptoms.

Facts About Treating EGFR-positive NSCLC

Learning more about EGFR-positive NSCLC and the targeted therapies available to treat it can help you feel a bit more comfortable as you begin or refine your treatment.

9 FAQs About Targeted Treatments for EGFR-positive NSCLC, Answered

Our experts weigh in on the top questions their patients ask about targeted therapy for EGFR-positive NSCLC.

Managing EGFR-positive NSCLC Symptoms and Treatment Side Effects

Dealing with both the symptoms of lung cancer and the side effects of treatment can be tough. Symptoms of later-stage lung cancer can include a persistent cough, a hoarse voice, loss of appetite, and shortness of breath, according to Jacoub. And typical side effects of targeted treatments for EGFR include diarrhea and skin rash, he adds.

Here are some ways to manage these common challenges:

In the case of more serious treatment side effects — such as lung inflammation — doctors can offer supplemental oxygen, antibiotics, or steroids if needed, Katz adds. You may also need to stop treatment.

If you experience these or other symptoms, don’t hesitate to let your doctor know. “The important thing is open and honest communication, and to ask questions,” Eaton notes.

Next Steps: Making Treatment Decisions

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Congratulations!

You’ve learned a lot about targeted treatments for EGFR-positive NSCLC. So, what’s next?

Take some time to absorb all this information and decide on your next steps.

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Self-Reflection

Before your next appointment, take some time to reflect on how you’re feeling about your diagnosis and potential treatment options. Think about:

  1. What are my goals for treatment?
  2. How have EGFR-positive NSCLC symptoms affected my quality of life to date?
  3. What are my biggest concerns as I begin treatment for EGFR-positive NSCLC?
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Doctor Discussion

Fully understanding your options and your treatment plan will help you get the most of your NSCLC treatment. Consider asking your doctor these questions:

  1. Which treatment are you prescribing for me? Why?
  2. What other facts do I need to know about targeted treatments before I take them?
  3. What can I do to get ready for treatment?
  4. What types of results do you expect? How soon might I notice them?
  5. If I’m concerned about the costs and insurance coverage for my treatment, what can I do?
  6. When should I come back to evaluate any progress?
  7. What are next steps if this treatment isn’t working as well as we’d hoped?