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Lung Cancer Treatment Today: Targeted Therapy, Immunotherapy and Biomarker Testing

November 12, 2026 · Lung Cancer, Cancer Treatment

An IV line taped to the back of a patient's hand.
Photo: Judy Beth Morris on Unsplash

Lung cancer treatment has changed dramatically. Not long ago, most people with advanced lung cancer had chemotherapy as their main option. Today, many are treated with drugs chosen for the specific changes in their tumor, or with medicines that help the immune system fight the cancer. If you or someone you love has lung cancer, here's what to know for Lung Cancer Awareness Month.

First, the type of lung cancer

About 80% to 85% of lung cancers are non-small cell lung cancer (NSCLC), and about 10% to 15% are small cell lung cancer, which grows and is treated differently. This article focuses on NSCLC. Treatment depends mainly on the stage of the cancer, along with your overall health and lung function, and often combines several approaches: surgery, radiation, chemotherapy, targeted therapy and immunotherapy. See our overview of lung cancer treatment.

Biomarker testing comes first

Biomarker testing (also called tumor testing or genomic testing) looks for changes in genes, proteins and other substances in the cancer that can help guide treatment. For NSCLC, it can show whether the tumor has a change that a targeted drug can attack, and how likely it is to respond to immunotherapy.

  • Testing is usually done on tissue from a biopsy or surgery.
  • When a tumor biopsy isn't safe, a liquid biopsy that looks for cancer DNA in a blood sample may be used.
  • Costs and coverage vary. According to the National Cancer Institute, Medicare and Medicaid cover some tests for advanced cancer, and private insurers often cover tests with enough evidence behind them. Check with your plan.

If you have NSCLC, ask your doctor: "Has my tumor had biomarker testing, and what did it show?"

Targeted therapy

Targeted drugs act on specific gene changes in cancer cells. They're mainly used for advanced lung cancer, alone or with chemotherapy, and most are pills. Gene changes with approved targeted drugs include:

  • EGFR mutations, treated with drugs such as osimertinib, erlotinib, gefitinib and afatinib, and amivantamab for certain EGFR changes
  • ALK rearrangements, treated with drugs such as alectinib, lorlatinib and brigatinib
  • ROS1 rearrangements
  • BRAF V600E mutations
  • KRAS G12C mutations, treated with sotorasib or adagrasib
  • MET exon 14 skipping
  • RET rearrangements
  • NTRK gene fusions
  • HER2 (also called ERBB2) mutations

Side effects depend on the drug. They can include rash and skin or nail changes (especially with EGFR drugs), diarrhea, nausea, tiredness, vision changes and changes in blood tests. Less common but serious effects include lung inflammation and liver or heart problems, so report new symptoms to your team promptly.

Immunotherapy

Cancer cells can use certain proteins as "brakes" to hide from the immune system. Drugs called checkpoint inhibitors release those brakes so the immune system can attack the cancer. For NSCLC they include:

  • PD-1 inhibitors: pembrolizumab (Keytruda), nivolumab (Opdivo) and cemiplimab (Libtayo)
  • PD-L1 inhibitors: atezolizumab (Tecentriq) and durvalumab (Imfinzi)
  • CTLA-4 inhibitors: ipilimumab (Yervoy) and tremelimumab (Imjudo), used only together with a PD-1 or PD-L1 drug

These drugs may be given alone or with chemotherapy, before or after surgery for earlier-stage cancer, or long-term for advanced cancer. A lab test for PD-L1, a protein on cancer cells, can help show whether they're likely to work. Most are given by IV infusion, and some can now be given as a shot under the skin.

Common side effects include tiredness, cough, nausea, itching, rash, loss of appetite, joint pain and diarrhea. Because these drugs boost the immune system, it can sometimes attack healthy organs, such as the lungs, intestines, liver, hormone glands or kidneys. Tell your care team right away about new symptoms such as a cough or shortness of breath, diarrhea, or yellowing of the skin, even months into treatment. These reactions are often treatable, sometimes by pausing the drug and giving steroids.

Clinical trials

Many of today's lung cancer treatments came from clinical trials, and trials remain a way to get access to promising new drugs. Ask whether one might fit you, and browse lung cancer clinical trials.

Questions to ask your care team

  • What type and stage of lung cancer do I have?
  • Has my tumor had full biomarker testing, including PD-L1?
  • Is there a targeted drug or immunotherapy for my cancer?
  • What side effects should I watch for, and who do I call about them?
  • Is there a clinical trial I should consider?

Our directory can help you find oncologists and cancer treatment centers, including research centers where many trials take place.

The bottom line

For non-small cell lung cancer, the tumor's biomarkers can shape the whole treatment plan. Make sure testing is done, ask what it found, and ask whether targeted therapy, immunotherapy or a clinical trial is right for you.

This article is for general information and is not medical advice. Talk with your doctor about your own situation.

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