How Is Targeted Therapy Changing Non–Small Cell Lung Cancer Treatment?

In this interview with Targeted Oncology^TM, Matthew Gubens, MD, MS, professor of medicine and thoracic oncologist at UCSF Health describes how targeted therapies are increasingly moving beyond metastatic cancer into earlier-stage disease, creating new opportunities to improve outcomes and potentially cure more patients, according to an oncology expert discussing advances in precision medicine.

Gubens highlights the growing use of targeted agents in adjuvant treatment and consolidation therapy after chemoradiation. Trials involving ALK- and RET-targeted therapies demonstrate the potential to improve progression-free and overall survival in earlier stages of cancer. Although enrolling enough patients for trials involving rare molecular subgroups can be challenging, successful accrual in these studies underscores growing interest in bringing targeted treatments into potentially curative settings.

These developments also strengthen the rationale for next-generation sequencing (NGS) in patients with early-stage disease. Identifying actionable mutations and gene fusions earlier may help clinicians determine whether patients are candidates for targeted therapy trials and expand treatment options beyond the metastatic setting.

The discussion also focuses on how clinicians can manage resistance to targeted therapies. When patients with metastatic disease progress on treatment, circulating tumor DNA testing and tissue biopsy with NGS can help identify molecular changes that may guide subsequent treatment decisions. Understanding resistance mechanisms is particularly important as the number of available targeted therapies increases.

Gubens points to EGFR-mutated lung cancer as an example of a treatment landscape in which sequencing therapies has become increasingly important. As more targeted agents become available, clinicians must consider not only which treatment to use, but also the order in which therapies should be administered.

These strategies may extend beyond EGFR, ALK, and RET to other cancers driven by actionable mutations and gene fusions. Together, earlier molecular testing, targeted therapy trials, and resistance profiling are helping shape a more personalized approach to cancer care, with the goal of improving long-term outcomes across disease stages.