Biological therapy for lung cancer

• A quick guide to what's on this page
• Types of biological therapy
• Erlotinib (Tarceva)
• Gefitinib (Iressa)

• Cetuximab (Erbitux)
• Bevacizumab (Avastin)
• Side effects of biological therapies
• Getting more information

Biological therapy is treatment with substances that are made naturally in the body. We can now make some of these substances in the laboratory and use them in much larger amounts for cancer treatment. Several types of biological therapy are now used to treat advanced lung cancer. They include erlotinib (Tarceva), gefitinib (Iressa), cetuximab (Erbitux), and bevacizumab (Avastin). Research is also looking at using some biological therapies to treat earlier stages of lung cancer.

Erlotinib is also known by its brand name, Tarceva (tar-see-vah). You take it as a tablet. Erlotinib works by blocking 'epidermal growth factor receptors' (EGFR) on cells. So your cancer cells will be checked to see if they have EGF receptors before you have this treatment. Cancers that have EGF receptors on their cells are called EGFR positive.

Erlotinib is used to treat patients with advanced non small cell lung cancer that has continued to grow despite having chemotherapy. Or as an alternative to docetaxel chemotherapy for people who have already had one course of chemotherapy that hasn't worked. Researchers are looking at whether erlotinib could be better than chemotherapy as a first treatment to control advanced non small cell lung cancer that is EGFR positive.

Erlotinib is not currently used as standard treatment for early stage non small cell lung cancer (NSCLC) but trials are looking at whether erlotinib can reduce the chance of NSCLC coming back after surgery. Trials are also looking at whether erlotinib with radiotherapy to the head can reduce the chance of lung cancer spreading to the brain. Some trials are combining erlotinib with chemotherapy or other biological therapy drugs. You can find out more about research into erlotinib for lung cancer on our what's new in lung cancer page.

Gefitinib is also called Iressa or ZD 1839. It is a type of tyrosine kinase inhibitor (TKI). It is used to treat advanced non small cell lung cancer that has receptors for epidermal growth factor receptor on the cell surface. 

The National Institute for Health and Clinical Exellence (NICE) is due to issue guidance about the use of gefitinib in the NHS later in 2010.

Cetuximab is a monoclonal antibody which blocks growth factor receptors on cells. It has been used, with chemotherapy, in trials for advanced non small cell lung cancer. The results so far have been quite encouraging, in terms of helping people to live longer. Research is continuing to try to find the best way of using cetuximab.

Bevacizumab (also called Avastin) is a monoclonal antibody (MAB) that stops cancer cells making the blood vessels they need so that they can grow. In August 2007, bevacizumab was licensed in Europe to treat advanced non small cell lung cancer in combination with platinum based chemotherapy, such as cisplatin or carboplatin. This treatment has not been approved by the National Institute for Health and Clinical Exellence (NICE) and so is not used as a standard treatment on the NHS in the UK.

The side effects will vary depending on which drug you have. But the possible side effects of biological therapies for lung cancer include

• Tiredness (fatigue)
• Diarrhoea
• Skin changes (rashes or discolouration) - rashes may be severe for some people
• A sore mouth
• Weakness
• Loss of appetite
• Low blood counts
• Swelling of parts of the body, due to build up of fluid

Tell your doctor if you have any of these as you can have medicines to help to control them. There is information about the side effects of individual biological therapies in our biological therapy section.

Look at the main biological therapy section in CancerHelp UK for detailed information. You can ask your doctor or specialist nurse to write down the names of the drugs you will have so you can look them up in our specific drug side effects section. There are pages there for all the most commonly used biological therapy drugs. Each page has information about common, occasional and rare side effects for that drug.

Our lung cancer organisations page gives details of people who can give information about lung cancer biological therapies. Some organisations can put you in touch with a cancer support group. Our lung cancer reading list has information about books and leaflets on lung cancer treatments.