Lewis said two helicopters were called to the crash scene near the 17.5-mile marker.
Lewis said the truck left the roadway and hit an embankment after the collision with the four-door sedan.
Traffic on the highway was shut down but vehicles were rerouted off U.S. 40.
Lewis credited the Maryville and Troy fire and rescue crews with quick action in treating the victims.
He did not have information on whether the drivers were wearing seat belts. He said there were no passengers in the vehicles.