Targeted Therapy or Immunotherapy: Which Is Better for Advanced Lung Cancer?
                     Targeted Therapy or Immunotherapy: Which Is Better 
for Advanced Lung Cancer?
Introduction
 Lung cancer continues to be one of the most serious and 
widespread cancers in the world, particularly in its advanced 
stages. For patients diagnosed with advanced lung cancer, the 
landscape of treatment options has changed dramatically in 
recent years. Traditional chemotherapy is no longer the only 
route. Instead, targeted therapy and immunotherapy have 
emerged as cutting-edge approaches, offering new hope.
 But when it comes to targeted therapy vs immunotherapy, which 
is the better choice for advanced lung cancer? The answer 
depends on various factors, including the type of lung cancer, 
genetic mutations, and how a patient’s body responds to specific 
treatments. In this comprehensive guide, we’ll explore both 
options, their benefits, risks, and how patients can make informed 
decisions with the help of experts at Action Cancer Hospital.
Understanding Advanced Lung Cancer
 Before we delve into the treatments, it's essential to 
understand what advanced lung cancer means. In 
general, it refers to stage III or stage IV lung cancer,
 where the cancer has spread beyond the lungs to 
other parts of the body or nearby tissues. The two main 
types of lung cancer are:
 Non-Small Cell Lung Cancer (NSCLC) – The most 
common type, accounting for about 85% of cases.
 Small Cell Lung Cancer (SCLC) – A more aggressive 
and fast-growing form.
 The treatment approach depends largely on the type 
of lung cancer and how far it has progressed.
What is Targeted Therapy?
 Targeted therapy is a form of cancer treatment that uses drugs designed 
to "target" specific genes or proteins that are involved in the growth and 
survival of cancer cells. Unlike chemotherapy, which affects both 
healthy and cancerous cells, targeted therapy focuses only on 
the molecular abnormalities within cancer cells.
 How Does Targeted Therapy Work?
 Targeted drugs block the action of certain enzymes, proteins, or 
molecules that cancer cells need to grow. For example:
 EGFR inhibitors (like erlotinib or osimertinib) target mutations in 
the Epidermal Growth Factor Receptor.
 ALK inhibitors (like crizotinib or alectinib) target abnormal ALK gene 
fusions.
 ROS1 and BRAF inhibitors are used for less common mutations.
 These drugs are usually given orally and are often well-tolerated 
compared to chemotherapy.
What is Immunotherapy?
 Immunotherapy works by boosting the body’s own immune 
system to fight cancer. Unlike targeted therapy, which aims at 
cancer cell features, immunotherapy activates immune cells 
to identify and destroy those cells.
 How Does Immunotherapy Work?
 Immune checkpoint inhibitors are the most commonly used 
immunotherapies for lung cancer. These include:
 PD-1 inhibitors (like nivolumab and pembrolizumab)
 PD-L1 inhibitors (like atezolizumab and durvalumab)
 CTLA-4 inhibitors (like ipilimumab)
 These drugs unblock immune responses that cancer cells often 
suppress, enabling T-cells to attack tumors more effectively.
Key Differences Between Targeted Therapy and Immunotherapy
Feature Targeted Therapy Immunotherapy
Mechanism Targets specific genetic mutations Activates the immune system
Suitable For Patients with identifiable 
Patients with high PD-L1 
mutations (EGFR, ALK, etc.) expression or no targetable mutations
Speed of Action Often produces quick results May take longer to show effects
Side Effects Usually mild (rash, diarrhea) Can be severe (autoimmune-like effects)
Testing Required Genetic or molecular testing PD-L1 testing or tumor mutational burden
Genetic Testing: The First Step in Personalized Treatment
 One of the most critical components of lung cancer treatment 
today is genetic and biomarker testing. Before choosing between 
targeted therapy or immunotherapy, doctors at Action Cancer 
Hospital conduct comprehensive molecular profiling of the tumor.
 Why this matters:
Without knowing the genetic makeup of the tumor, it's nearly 
impossible to select the most effective treatment. For instance:
 A patient with an EGFR mutation will benefit more from EGFR 
inhibitors than from immunotherapy.
 If no mutations are found but PD-L1 levels are high, 
immunotherapy may be the first line of treatment.
When is Targeted Therapy the Best Choice?
 Targeted therapy is usually the preferred option for patients who test 
positive for specific genetic alterations. These include:
 EGFR
 ALK
 ROS1
 BRAF
 MET
 RET
 NTRK
 Patients with these mutations often respond dramatically and quickly to 
targeted drugs, with fewer side effects compared to chemotherapy.
 Real-world impact: Many patients experience prolonged survival and 
improved quality of life with targeted treatments.
When is Immunotherapy the Best Choice?
 Immunotherapy is often recommended when:
 No targetable genetic mutations are found.
 PD-L1 expression is high (≥50%).
 The cancer has progressed despite previous treatments.
 The patient is not eligible for targeted therapy due to 
resistance or other medical conditions.
 Bonus: Immunotherapy can also be used 
in combination with chemotherapy, especially in cases 
of widespread or aggressive cancer.
Can Targeted Therapy and Immunotherapy Be Combined?
 Although both therapies are effective in their own 
right, combining them is not always beneficial. In 
fact, studies have shown that certain combinations 
can increase toxicity or even reduce efficacy.
 However, in some cases, sequential treatment—
using targeted therapy first and then 
immunotherapy—may be considered, especially 
when resistance develops.
 Doctors at Action Cancer Hospital carefully 
evaluate such strategies using individualized 
treatment plans and ongoing monitoring.
What Are the Side Effects of Each Treatment?
 Immunotherapy Side Effects Immunotherapy Side Effects
 Inflammation (lungs, liver, intestines) Inflammation (lungs, liver, intestines)
 Endocrine problems (thyroid, adrenal Endocrine problems (thyroid, adrenal glands)
glands) Skin rashes
Fatigue
 Skin rashes
 Fatigue These are immune-related adverse effects and may 
immune-related adverse require steroid treatment or even treatment  These are 
effects and may require steroid discontinuation in severe cases.
treatment or even treatment 
discontinuation in severe cases.
What’s the Outlook for Patients?
 Thanks to advances in both targeted therapy and immunotherapy, 
the survival rates for advanced lung cancer patients have 
significantly improved over the past decade. Some patients now 
live for several years after diagnosis—something that was once rare 
for stage IV lung cancer.
 Here’s how these therapies have changed the game:
 Targeted therapy can offer rapid relief from symptoms and disease 
control for years—especially with newer-generation inhibitors.
 Immunotherapy has shown durable responses in some patients, 
even leading to long-term remission.
 However, it's important to note that not all patients respond, and 
some may experience disease progression despite treatment. That's 
why regular follow-ups, imaging, and blood tests are essential parts 
of the treatment journey at Action Cancer Hospital.
Conclusion: The Best Treatment is a Personalized One
 So, what’s better—targeted therapy or immunotherapy?
 The truth is, there is no one-size-fits-all answer. The best treatment depends on a patient's 
unique biology, cancer type, genetic makeup, and overall health. That’s why Action 
Cancer Hospital uses a personalized, precision medicine approach to lung cancer care.
 With cutting-edge diagnostic tools, experienced oncologists, and patient-centric care, 
Action Cancer Hospital helps patients navigate the complexities of advanced lung 
cancer with clarity and confidence.
 If you or your loved one is facing a lung cancer diagnosis, consult the experts at 
Action Cancer Hospital today to explore the best possible treatment options tailored just 
for you.
Thank You
Head Office - Action Cancer HELPLINE NO: 011-49-222-222 EMAIL: [email protected]
Hospital A - 4, Paschim Vihar,     EMERGENCY NO: 011-49-222-233    
Near Paschim Vihar East Metro AMBULANCE NO: 011-42-888-777
Station New Delhi - 110063