![]() ![]() For these patients, there was a confirmation of this similar response, with a little more than 80% of patients responding to selpercatinib with their CNS disease. Twenty-two additional patients had measurable CNS disease, with multiple different fusion partners. Of the 11 patients who had intracranial disease that was measurable, 91% responded, with one-third of them having a complete response and two-thirds a partial response, and the DOR intracranially was also significant, with a decent amount of 10.1 months. We also saw from this study that there was an intracranial response for patients who had measurable intracranial disease. This was a significant duration of disease control, and those responses were seen regardless of the type of prior treatment, as well as regardless of the RET fusion partner. Then I think what we are looking to more and more is the duration of response when people do respond, and the DOR was not reached in the treatment-naive cohort and was about 18 months in the prior platinum chemotherapy. The response in the prior treatment cohort was 64% to 70%, depending on which assessment, whereas in treatment-naive patients it was 85% to 90%. What was most impressive from this study were the response rates that we saw in both the patients who had platinum chemotherapy previously and the patients who were not previously treated. What was the efficacy of the LIBRETTO-001 trial? There were patients who had brain metastases in both cohorts, and the KIF5B- RET fusion was the most common. They had adenocarcinoma, and in the, they all had had platinum-based chemotherapy and some already had a multitargeted tyrosine kinase inhibitor. On the LIBRETTO-001 trial, the patients in both cohorts were similar in age, race, and ECOG status. 3 It was a large trial that had several cohorts, and we’ll briefly discuss the data from the RET fusion–positive metastatic NSCLC cohort, which had 2 cohorts within that cohort, 1 of which was treatment naive, and the second was patients who were previously treated with platinum chemotherapy. The LIBRETTO-001 trial was a phase 1/2 trial that used selpercatinib in patients with RET fusion–positive NSCLC. ![]() Which trials back the approval and recommendation of selpercatinib? What treatments are recommend for these patients?Ĭertainly, from the National Comprehensive Cancer Network guidelines and the FDA perspective, both selpercatinib and pralsetinib have been approved, and they’re both listed as preferred on the NCCN guidelines. We also know that there is a difference between mutation and fusion, and that fusions are the predominant mechanism in lung cancer, with the KIF5B being the most common fusion that we see, in about 70% to 90% of patients with lung cancer. Targeted Oncology TM: How often are RET mutations seen in patients with cancer?īAUMAN: RET fusions and mutations are associated with oncogenesis across multiple different malignances, the most common being papillary thyroid cancer, medullary thyroid cancer, and non–small cell lung cancer, though there have been RET alterations seen in other places. ![]() Review of these data were part of a discussion about a 59-year-old patient during a virtual Targeted Oncology Case-Based Roundtable event. ![]() Jessica Bauman, MD, the chief, Division of Head and Neck, Medical Oncology, assistant professor, Department of Hematology/Oncology, and associate program director, Hematology/Oncology Fellowship Training Program at Fox Chase Cancer Center, reviewed data from the LIBRETTO-001 and ARROW trials which show the efficacy and safety of selpercatinib (Retevmo) and pralsetinib (Gavreto) for the treatment of patients with RET fusion-positive lung cancer. ![]()
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