Despite 2021 being another challenging year, we saw treatment options for lung cancer increase by leaps and bounds. In 2021 the treatment landscape for lung cancer evolved to provide breakthrough treatment options targeting mutations that were previously unavailable for patients. Additionally, new immunotherapy options were approved, giving more variety and treatment options as well as post-surgery options.

Targeted Therapy Approvals

In the targeted therapy space, there were five total approvals, three of which were for previously untargetable mutations. This means that before 2021, patients with these specific mutations targeted by the three drugs had no FDA approved options outside of chemotherapy and immunotherapy. The other two approvals opened up additional treatment options for patients who may have otherwise been limited.

New Drugs for New Targets

The three drugs targeting new mutations are Lumakras (sotorasib), Rybrevant (amivantamab-vmjw), and Exkivity (mobocertinib). Lumakras received approval for patients with non-small cell lung cancer (NSCLC) that has spread outside of the lungs and has the KRAS G12C mutation. Lumakras can only be received after a patient has tried at least one form of systemic treatment. Rybrevant and Exkivity both received approval for patients with locally advanced or metastatic NSCLC that has the EGFR exon 20 insertion mutation. Both Rybrevant and Exkivity can only be received after a patient has tried at least one platinum doublet chemotherapy.

New Drugs for Existing Targets

The two drugs approved in 2021 that target existing mutations are Tepmetko (tepotinib) and Lorbrena (lorlatinib). Tepmetko received approval for patients with NSCLC that has spread outside of the lungs and has a MET exon 14 skipping mutation. Prior to Tepmetko, the only drug available to these patients was Tabrecta (capmatinib). Lorbrena received approval for patients with NSCLC that has spread outside of the lungs and is ALK+. Prior to the approval of Lorbrena, patients relied on other drugs.

Immunotherapy Approvals

In 2021, one new immunotherapy drug received approval and one already approved drug received additional use for lung cancer patients. The newly approved drug is Libtayo (cemiplimab-rwlc) which is a PD-1 inhibitor. Libtayo received approval for first line treatment of patients with locally advanced or metastatic NSCLC that does not have other actionable mutations like EGFR and ALK and high PD-L1 expression. Libtayo represents another important option for patients who rely on immunotherapy. Tecentriq (atezolizumab) received an important addition to its FDA label in 2021, opening it as an option for patients than before. Tecentriq is now approved for patients who received surgery and chemotherapy after their surgery and have at least 1% PD-L1 expression. Tecentriq is the first immunotherapy approved for this adjuvant setting in early-stage NSCLC.

Small Cell Lung Cancer (SCLC) Approvals

While we didn’t see additional treatment approvals for SCLC in 2021, there was a therapy approval to help mitigate a side effect that many patients with SCLC experience from their chemotherapy called neutropenia or bone marrow suppression. Neutropenia makes it harder for patients to fight dangerous infections and can impact quality of life. The name of the newly approved drug is Cosela (trilaciclib) and it is the first drug to help patients experiencing this side effect.

There are still many drugs being studied in clinical trials that could be options for you or a loved one. If you would like to discuss any treatment or clinical trial options, please call our free HelpLine at 1-800-298-2436 and ask to speak to an expert LungMATCH navigator.