Treatment for lung cancer
Targeted cancer drugs work by targeting specific genetic changes in cancer cells that help cancer grow and survive. Immunotherapy helps the body’s immune system recognise and attack cancer cells.
Some treatments work in more than one way. So, they are targeted as well as working with the immune system.
Read more about targeted cancer drugs
Whether you have targeted therapy or immunotherapy depends on:
the type of lung cancer you have
how far the cancer has grown (the stage)
treatment you may have already had
whether your cancer has changes () in certain proteins or
You might have a targeted drug for:
cancer that has been completely removed with surgery (for example, stage 1B to 3A)
locally advanced cancer
metastatic (advanced) cancer
You might have immunotherapy:
after surgery for some early stage cancers
before or after surgery for some stage 2 and stage 3 cancers
for metastatic (advanced) cancer
You might have immunotherapy with chemotherapy.
Read more about the stages of lung cancer
Doctors test your cancer for specific gene changes (mutations). These results help them decide whether targeted drugs or immunotherapy may be suitable for you.
They look for changes in the:
epidermal growth factor receptor (EGFR) gene
anaplastic lymphoma kinase (ALK) gene
ROS1 gene
mesenchymal-epithelial transition (MET) gene
RET gene
KRAS gene
neurotrophic tyrosine receptor kinase (NTRK) gene
BRAF V600 gene
They usually test a sample of your lung cancer tissue from when you were first diagnosed. Or from your operation if you had one. Some tests look for cancer DNA in blood samples. This is called a liquid biopsy.
The results of the tests show whether a targeted cancer drug or immunotherapy is suitable for you.
If your cancer has a particular gene change, your doctor will call it positive for the change. For example, EGFR mutation positive.
There are lots of different targeted cancer drugs and immunotherapy drugs. You usually have one drug on its own. Sometimes you might have it with other treatments, such as chemotherapy. Your doctor will tell you which drug is suitable for you.
New cancer drugs are licensed for use in a particular way. For example, a drug might have a license to treat a particular stage or type of lung cancer.
After a drug is licensed, several independent organisations approve the new cancer drugs before doctors can prescribe them on the NHS.
In England, the National Institute for Health and Care Excellence (NICE) decides which drugs and treatments are available on the NHS.
In Wales, the All Wales Medicines Strategy Group (AWMSG) advises NHS Wales. They often follow NICE decisions but can also issue their own guidance.
In Scotland, the Scottish Medicines Consortium (SMC) makes separate decisions for NHS Scotland.
Some of the below drugs might not be available throughout the UK. It might depend on where you live whether you can have a certain drug. Your doctor will be able to tell you what drug is available for you.
Read about access to treatment
Epidermal growth factor receptor (EGFR) is a protein on the surface of cells. It helps the cells grow and divide. Some cancers have a change (mutation) in the EGFR gene, which can make the cancer cells grow faster. Drugs called EGFR inhibitors can block EGFR signals and slow or stop cancer growth. These drugs are also called tyrosine kinase inhibitors or TKIs. The best treatment for you depends on:
the exact type of EGFR mutation
how advanced the cancer is
your general health and preferences
Your healthcare team will explain the benefits and possible side effects of each option and help you decide which treatment is right for you. You might have an EGFR inhibitor called osimertinib as first line treatment:
on its own for untreated locally advanced or metastatic NSCLC
with pemetrexed and platinum-based chemotherapy for untreated advanced NSCLC
after surgery for stage 1B to 3A NSCLC to reduce the risk of the cancer coming back
if the cancer grows back (recurrent cancer) after treatment with another EGFR inhibitor
Another first-line treatment for some people is a combination of:
lazertinib (an EGFR inhibitor), and
amivantamab (an antibody that targets EGFR and MET)
Your doctor will discuss whether this combination, osimertinib on its own, or osimertinib with chemotherapy is the best option for you. Other EGFR inhibitors you might have include:
gefitinib (Iressa)
afatinib (Giotrif)
erlotinib (Tarceva)
dacomitinib (Vizimpro)
About 5 in 100 people (5%) with NSCLC have a change in a gene called anaplastic lymphoma kinase (ALK). This gene change can happen when ALK joins with another gene. The gene change sends signals that make cancer cells grow and divide.
Drugs called ALK inhibitors can block these signals and help control the cancer. You usually have one of these drugs as a first treatment for metastatic NSCLC. They include:
alectinib (Alcensa)
brigatinib (Alunbrig)
crizotinib (Xalkori)
ceritinib (Zykadia)
Alectinib is also an option for metastatic NSCLC if you previously had treatment with crizotinib.
You may have alectinib also for stage 1B (cancer 4cm or larger) to 3A NSCLC after surgery to completely remove the cancer.
Brigatinib (Alunbrig) is a treatment for metastatic NSCLC if you haven’t had treatment with an ALK inhibitor before. You might also have it for metastatic NSCLC if you’ve had treatment with crizotinib before.
Lorlatinib (Lorviqua) is an ALK inhibitor that you may have:
after other treatments stopped working
if you haven’t had treatment with an ALK inhibitor before
The ROS1 gene change is similar to the ALK gene change. This change means that the cancer receives signals to grow. Some targeted drugs block these signals. The following drugs are used for metastatic NSCLC if you haven't had any other ROS1 inhibitors before. They include:
crizotinib (Xalkori)
entrectinib (Rozlytrek)
repotrectinib (Augtyro)
taletrectinib (Ibtrozil)
Some lung cancers have a gene change called a (MET) exon 14 skipping mutation. A targeted drug called tepotinib (Tepmetko) can be used to treat this type of cancer. It is a treatment for metastatic NSCLC.
A RET gene fusion happens when the RET gene joins with another gene, causing cancer cells to grow.
A targeted drug called selpercatinib (Retsevmo) is recommended for treating locally advanced or metastatic NSCLC with a RET gene fusion. You might have it as a first line treatment. Or you might have it after other treatments, if you have not had a RET inhibitor before.
Some lung cancers have changes in a gene called K-RAS. The K-RAS gene is important in controlling cell growth. Changes to this gene can lead to cells growing and dividing out of control to form cancers. A drug that targets a specific type of this gene change is called sotorasib (Lumakras).
Sotorasib is a treatment for locally advanced or metastatic NSCLC if your cancer has started to grow again after treatment with platinum based chemotherapy or immunotherapy.
An NTRK gene fusion happens when a part of the NTRK gene breaks off and joins with another gene. This can lead to abnormal proteins called TRK fusion proteins. These proteins make cancer cells grow.
Targeted cancer drugs can block these proteins and help control the cancer. For people with locally advanced or metastatic NSCLC with an NTRK gene fusion, treatments may include:
larotrectinib (Vitrakvi)
entrectinib (Rozlytrek)
Some lung cancers have a change in a gene called BRAF. This is often a specific change called V600E. This change can make the cancer grow and divide too quickly. A combination of dabrafenib and trametinib is a targeted treatment for locally advanced or metastatic non-small cell lung cancer (NSCLC) with a BRAF V600E mutation. These are targeted drugs that block this abnormal growth signal.
Some drugs block several growth signals that cancer cells use to grow. These are called multi-kinase inhibitors. Nintedanib (Vargatef) is a multi-kinase inhibitor. It is for people with a type of NSCLC called adenocarcinoma. You have it with a chemotherapy drug called docetaxel.
PD-1 means programmed cell death protein 1, and PD-L1 means programmed cell death ligand 1. They are called checkpoint proteins.
Checkpoint proteins are found on the surface of cells. PD-1 is found on a type of immune cell called a . PD-L1 on normal cells and often on cancer cells.
When PD-L1 on a cancer cell binds to PD-1 on a T cell, it switches the T cell off. The immune system then does not recognise the cancer cell as harmful and does not attack it. Immune checkpoint inhibitor drugs block the link between PD-1 and PD-L1. This allows T cells to recognise and kill cancer cells. There are two main types of checkpoint inhibitor:
PDL-1 inhibitors
PD-1 inhibitors
Types of PDL-1 inhibitors include:
You might have durvalumab:
after chemoradiotherapy for locally advanced NSCLC that cannot be removed with surgery
with chemotherapy before surgery (neoadjuvant), then on its own after surgery (adjuvant), for cancer that can be completely removed by surgery
You might have atezolizumab:
after surgery and adjuvant
for NSCLC that has not been treated before
for or metastatic NSCLC after chemotherapy
with bevacizumab, carboplatin and paclitaxel as a treatment for metastatic non squamous cell NSCLC
Types of PD-1 inhibitors include:
You might have pembrolizumab:
for metastatic NSCLC that has not been treated before
for NSCLC that has a high risk of coming back after being completely removed with surgery and after platinum chemotherapy
for NSCLC that can be removed completely with surgery and that has a high risk of coming back. You may have it before surgery with platinum chemotherapy and then after surgery as a treatment on its own
You might have nivolumab:
before surgery (neoadjuvant treatment) if your cancer can be removed with surgery
for locally advanced or metastatic squamous NSCLC
For extensive-stage small cell lung cancer, you usually have immunotherapy with chemotherapy if you are well enough. You have this as the first treatment, You might have:
atezolizumab (Tecentriq) with carboplatin and etoposide chemotherapy, or
durvalumab (Imfinzi) with etoposide and either carboplatin or cisplatin chemotherapy
After finishing chemotherapy you often continue immunotherapy on its own as maintenance treatment. You continue treatment for as long as it is helping and side effects are manageable.
For limited-stage small cell lung cancer, you usually have chemoradiotherapy (chemotherapy and radiotherapy together). You might then have durvalumab (Imfinzi) if the cancer has not grown. This may help reduce the risk of it coming back
For information about all these drugs and their side effects, go to the individual drug pages.
Last reviewed: 14 Jan 2026
Next review due: 15 Jan 2029
Lung cancer starts in the windpipe (trachea), the main airway (bronchus) or the lung tissue. Cancer that starts in the lung is called primary lung cancer.
The stage of a cancer tells you how big it is and whether it has spread. The type tells which type of cell the cancer started from.
Your treatment depends on several factors. These include what type of lung cancer you have, how big it is and whether it has spread (the stage). It also depends on your general health.
There is support available during and after treatment to help you cope. This includes support from your clinical nurse specialist, cancer charities, community services, and family and friends.
There are many cancer drugs, cancer drug combinations and they have individual side effects.
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