Lung cancer revolution: experts reveal details of breakthrough therapy

As an example, experts presented lung cancer patients with an activating mutation in the EGFR gene (the gene encoding the receptor for epidermal growth factor). These are mostly young people, non-smokers and more often women .

As emphasized by Dr. hab. Magdalena Knetki-Wróblewska from the Clinic of Lung and Chest Cancer of the National Center of Oncology - National Research Institute in Warsaw, the challenge associated with this type of lung cancer is that no one expects to be diagnosed with this cancer in non-smoking patients aged 40, 30 or even 20 .

Experts present at the conference recalled that approximately 22,000 cases of lung cancer are diagnosed in Poland each year.

- More than half of these patients have disseminated cancer or such advanced disease that we cannot offer them radical treatment - said Dr. Knetki-Wróblewska.

As many as 85% of all lung cancer cases are non-small cell lung cancer , of which 45% are adenocarcinoma. According to Prof. Paweł Krawczyk, head of the Immunology and Genetics Laboratory at the Medical University of Lublin, 10-14% of patients with this type of lung cancer have an activating mutation in the EGFR gene.

- Patients with lung cancer with molecular disorders have a much higher risk of developing brain metastases, which are the metastases with the worst prognosis. That is why we need to have the most effective drugs for them - emphasized Dr. Knetki-Wróblewska.

She reminded that lung cancer patients with EGFR mutations are treated with targeted therapy in the form of EGFR tyrosine kinase inhibitors. "These drugs have proven to be more effective than chemotherapy previously used in all patients. They allow for longer survival without disease recurrence, extend overall survival and are better tolerated," the specialist listed.

She recalled that 15-20 years ago, most patients treated with chemotherapy died within a year of diagnosis . Thanks to targeted drugs, survival time has been extended to about 4 years.

Recently, it has turned out that the treatment results for these patients can be further improved by adding chemotherapy to the targeted drug or - the latest achievement in medicine - bispecific antibodies, noted Dr. Knetki-Wróblewska.

- This applies especially to patients with brain and liver metastases. These are patients who do not respond as well to monotherapy with a targeted drug as we would like - explained the specialist.

She emphasized that the additional use of chemotherapy or a bispecific antibody prolonged the time to disease progression and overall survival, especially in patients with brain metastases.

In the opinion of Dr. Knetka-Wróblewska, in patients who are at higher risk of rapid disease relapse, treatment should be intensified early - by adding chemotherapy or a bispecific antibody.

- Thanks to the combination of an oral tyrosine kinase inhibitor with the first bispecific anti-EGFR and anti-MET antibody, a spectacular extension of progression-free survival and overall survival was achieved - said Prof. Krawczyk.

He added that the combination of a bispecific antibody with chemotherapy is the only therapeutic option that brings therapeutic benefits in the first line of treatment in patients with a rare EGFR gene mutation - the so-called exon 20 insertion. Additionally, the bispecific antibody is effective in the so-called second line of treatment in patients with a mutation in the EGFR gene treated with a targeted drug, in whom the disease has progressed.

Dr. Knetki-Wróblewska noted that from July 1, 2025, lung cancer patients with EGFR mutations will have the option of using oral targeted drugs in combination with chemotherapy in Poland .

Bispecific antibodies are not currently reimbursed for this group of patients.

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