Emerging Therapies in Lung Cancer: A Review on Targeted and Immune Based Interventions

Abstract

Lung cancer continues to be the foremost cause of cancer-related mortality globally, with non-small cell lung cancer (NSCLC) accounting for nearly 85% of cases. Historically, the prognosis for NSCLC was grim, but advancements in targeted therapies and immunotherapy are transforming treatment paradigms. This review encapsulates significant developments in molecularly targeted agents and immune checkpoint inhibitors, emphasising their clinical efficacy, resistance mechanisms, and innovative therapeutic combinations. A thorough literature search was conducted across PubMed, ClinicalTrials.gov, and other global intellectual property databases to highlight pivotal advancements in lung cancer therapies. Each section focuses on therapies targeting key molecular drivers such as Epidermal Growth Factor Receptor (EGFR), Anaplastic Lymphoma Kinase (ALK), and others, alongside immunotherapies targeting critical pathways like PD-1 and PD-L1. In genetically defined NSCLC subsets, targeted therapies such as Osimertinib and Lorlatinib have significantly enhanced progression-free survival. Similarly, immune checkpoint inhibitors like Nivolumab have redefined care standards, particularly in PD-L1-positive tumours. Nevertheless, challenges such as acquired resistance persist, prompting ongoing exploration of combination strategies and next-generation agents. This article also reviews pivotal clinical trials and newly filed patents, reflecting current and emerging commercial interests. The integration of molecular diagnostics and precision therapies is reshaping lung cancer treatment, with prospective directions aiming to overcome resistance and broaden access to innovative therapies worldwide, including from India and other developing regions.