8 Promising New Lung Cancer Treatments on the Horizon

A lung cancer diagnosis is a life-changing event for too many people. It’s the third most common cancer in the U.S., and it’s the leading cause of cancer-related death. So if this diagnosis is a new reality for you or a loved one, it’s only natural if you’re thinking about the available treatment options.

Even though much has happened in the last 10 years to improve outcomes and lengthen survival for those with lung cancer, there is still a lot to do. The good news is that many new medications are being studied in clinical trials.

What types of medications are currently used for lung cancer?

In addition to surgery and radiation, three types of medications are available to treat lung cancer. These are chemotherapy, targeted therapy, and immunotherapy. Many medications within each of these umbrellas are available, and most of them have very specific uses. Based on your situation, your cancer specialist can help you decide if one or more of these treatments are right for you. 

But what happens if these treatments don’t work? Or they aren’t an option for you? Thankfully, there’s a lot of research being done in clinical trials for lung cancer. 

What are clinical trials?

A clinical trial is a type of research that studies new medications. There are four clinical trial phases to see if a treatment is safe and effective:

• Phase 1 trials are small, early stage studies. They test a medication in a small number of people to find a safe dose and learn about side effects.

• Phase 2 trials are mid-size studies that begin to analyze how safe and effective a medication is. 

• Phase 3 trials are larger studies that analyze hundreds to thousands of people. They get more information about how safe and effective a new medication is compared to current treatment options.

• Phase 4 trials happen after a medication is FDA approved. They study a medication’s long-term safety and effectiveness. 

The FDA is responsible for reviewing information from clinical trials. Based on clinical trial results, they can decide to approve a medication and make it available to the public. Most medications are approved after they review phase 3 trial data. However, medications are sometimes approved after phase 2 trials instead. Treatments that are approved after phase 2 trials usually need phase 3 data later on to further prove that they’re effective.

In cancer research, approvals are often based on endpoints like response rate. This is a measure of how many tumors (cancers) get better because of a treatment in clinical trials. 

What new lung cancer treatments are currently in clinical trials?

Several medications are actively being studied in clinical trials. They may be approved if they help people with lung cancer live longer and don't have too many side effects. Below, we review the late-phase treatments that are being studied to treat non-small cell lung cancer (NSCLC).

Adagrasib

Some lung cancers have mutations that allow them to grow. In these cases, a targeted therapy medication may be used to fight the mutation. One mutation is in a gene called KRAS. 

Adagrasib is an oral “small molecule” targeted therapy that singles out a mutation in the KRAS gene. Early clinical trial data reported a 43% response rate, showing that it has positive activity in KRAS-mutated lung cancers. The phase 3 KRYSTAL-12 trial is ongoing. It’s expected to be done by July 2024. 

So far, one medication is FDA approved to treat this specific form of lung cancer. Lumakras (sotorasib) was approved in 2021 after an initial report found that 37% of study participants responded to the medication. Lumakras hasn’t been directly compared to adagrasib yet, but it may become a good alternative option if approved.

Patritumab deruxtecan

Another lung cancer mutation affects the EGFR gene. Some of the more common EGFR mutations (sensitizing mutations) can be treated with targeted therapies like Tagrisso (osimertinib) or Gilotrif (afatinib). But over time, lung cancers with certain EGFR mutations can outsmart medications like Tagrisso, making them ineffective.

Patritumab deruxtecan is an upcoming antibody-drug conjugate (ADC) that may be able to treat these mutations. Patritumab is a monoclonal antibody that targets a protein called HER3. The antibody is attached to deruxtecan, a type of chemotherapy. Together, this ADC is given as an infusion into your vein (IV).

Patritumab deruxtecan is being studied in lung cancers that have these tough-to-treat mutations and haven’t responded to medications like Tagrisso. Early data showed that it may work, too — as about 28% of participants responded to the treatment in one small study. A phase 3 trial, HERTHENA-Lung02, is ongoing. It’s expected to finish by August 2026.

Poziotinib

Poziotinib is an oral small molecule targeted therapy being studied for EGFR exon 20 insertion-mutated lung cancer. A hard-to-treat form of cancer, a phase 2 study saw a 28% response rate among people taking poziotinib. The phase 3 PINNACLE trial is now underway, which is expected to be done by 2028.

Currently, two medications are FDA approved to treat this form of lung cancer. Exkivity (mobocertinib) is another small molecule targeted therapy taken by mouth. The other is Rybrevant (amivantamab), a targeted monoclonal antibody given as an IV infusion. A third medication, sunvozertinib, is being studied in earlier stage trials.

Are any other lung cancer treatments showing promise?

Some treatments are in earlier phases of research. It’ll be longer before they’re potentially approved. Here are some medications on the horizon.

EGFR inhibitors

Sunvozertinib

Another oral medication being studied for EGFR exon 20 insertion-mutated lung cancer is sunvozertinib. Early data showed that 48% of study participants responded to the treatment. 

Because of these positive results, sunvozertinib was granted a Breakthrough Therapy designation to help speed up its development process. Its phase 1/2 clinical trial, WU-KONG1, is expected to be done by early 2023.

Aumolertinib

Aumolertinib is an oral small molecule targeted therapy that’s similar to Tagrisso (osimertinib). It’s approved in China, but not approved in the U.S. It’s now being studied in the U.S., but the phase 3 trial isn’t scheduled to be done until 2027.

Amivantamab and lazertinib

Rybrevant (amivantamab) is an IV monoclonal antibody medication. It’s designed to treat lung cancer by targeting EGFR and MET proteins. It’s currently FDA approved to treat EGFR exon 20 insertion-mutated lung cancer, but it’s now being studied in combination with other medications to see if it works in different situations.

The phase 3 MARIPOSA trial is looking at how well Rybrevant works in combination with a targeted therapy called lazertinib. MARIPOSA-2, another phase 3 study, is looking at Rybrevant in combination with lazertinib and chemotherapy. These studies are scheduled to finish by November 2025.

MET inhibitors

Telisotuzumab vedotin 

Some lung cancers make too much of a protein called c-Met. There are currently no treatments that target this protein, so this form of lung cancer is usually treated with traditional chemotherapy. However, telisotuzumab vedotin (Teliso-V) is a developing ADC that targets tumors expressing c-Met.

A phase 2 trial is studying telisotuzumab vedotin treatment in people with lung cancer who express c-Met. In an initial report, 52% of patients with high c-Met expression responded to this medication. A phase 2 trial is expected to be completed by September 2025.

Savolitinib

Savolitinib is a small molecule targeted therapy that targets c-Met. It’s being studied for a unique purpose.

Some EGFR-mutated lung cancers develop new, secondary mutations that make tumors resistant to medications like Tagrisso. The phase 2 SAVANNAH trial is studying savolitinib in combination with Tagrisso in lung cancers with both mutated EGFR and c-Met. It should be completed by February 2025.

Treatments for small cell lung cancer

Small cell lung cancer (SCLC) is another type of lung cancer. It’s more aggressive than NSCLC, and it isn’t associated with any targetable mutations. Most of the clinical trials for SCLC are in phase 1 or 2.

How do I find out if I am eligible for a clinical trial?

The first step is to talk about your treatment options with your cancer specialist. If current treatment options aren’t effective for your situation, they may be able to connect you to a clinical trial for a new treatment. They can help you identify open trials you may be eligible for. What’s more, ask them about new measures being taken to make clinical trials available to more people. 

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Written by:

Emmeline C. Academia, PharmD, BCOP

Emmeline C. Academia, PharmD, BCOP, has been a practicing clinical pharmacist in adult oncology since 2020. She is a clinical pharmacy specialist in oncology at Beth Israel Deaconess Medical Center, in Boston.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Sonja Jacobsen, PharmD, BCPS, BCOP

Sonja Jacobsen, PharmD, BCPS, BCOP,  is a clinical oncology pharmacy specialist currently practicing in Seattle. She has been practicing as a pharmacist since 2015 and is licensed to practice in Washington state and North Carolina.

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