Selpercatinib and its Future in RET-Mutated Thyroid Cancer

Marcia S. Brose, MD, PhD, FASCO, professor in the Department of Medical Oncology Sidney Kimmel Medical College Thomas Jefferson University, professor and vice chair in the Department of Medical Oncology Jefferson Northeast, chief of Cancer Services, Sidney Kimmel Cancer Center-Jefferson Northeast, associate director of Community Based Clinical Research, and SKCC chair of Hematology/Oncology, Jefferson Torresdale Hospital, discusses her hopes for the future of selpercatinib (Retevmo) in treating advanced or metastatic RET-mutant thyroid cancer.

While selpercatinib is already an FDA-approved treatment option for patients with RET-mutated thyroid cancer, the robust phase 3 data from LIBRETTO-531 (NCT04211337) confirms its effectiveness and sets a high bar for future studies.

According to Brose, these findings should encourage wider patient access and highlight the importance of upfront genetic testing in personalized medicine. Further, she emphasizes how important it is to ensure that all patients with residual disease get analyzed for potential selpercatinib treatment.

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0:10 | It already is FDA-approved for these patients. My hope is that it will continue to fulfill the promise that we've seen in both studies, and that patients will get access to it, and that the results will continue. I also hope that we will continue to see strong results, and that we won't be disappointed in any way down the line.

0:48 | I do not anticipate that. I think this is probably 1 of the best studied drugs. It was thoroughly studied because a lot of times, when a company gets FDA approval, they don't necessarily get such a robust amount of data. A good example of that is the dabrafenib [Tafinlar] study. Dabrafenib was approved tumor agnostically, but in thyroid cancer, the data were poor.

1:14 | In this case, selpercatinib did get studied in a robust phase 3 study with appropriate controls. I think this is data that we're going to be able to count on for years to come. I hope that most people will get educated quickly, because I do think that this is a paradigm shift for the patients, and an important one. The other thing I hope that it will do, as somebody who specializes in personalized medicine, is bring to everybody's attention the importance of getting complete genetic analysis of patients upfront.

1:54 | If we know about these mutations, if we're going to treat them in the first-line, we have to know that those mutations exist before we start. It needs to be that we go in the direction of all patients who are not cured otherwise by surgery, that everybody who has residual disease in any way we get genetics on those patients, and we find out because this is an opportunity for these patients we wouldn't want to miss.