Selpercatinib Induced Durable Efficacy in RET Fusion-Positive NSCLC

Vivek Subbiah, MD, of the Department of Investigational Cancer Therapeutics, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the implications of the phase 1/2 LIBRETTO-001 study, which evaluated selpercatinib (formerly known as LOXO-292; Retevmo) as treatment of patients with RET fusion-positive non–small cell lung cancer (NSCLC).

Durable efficacy was observed with selpercatinib in patients with RET fusion-positive NSCLC who had been previously treated with platinum-based chemotherapy, as well as intracranial activity. Fewer than 15% of patients experienced grade 3 or higher adverse events, Subbiah notes.

Interestingly, selpercatinib induced durable efficacy in previously untreated patients as well, Subbiah says. It is estimated that RET occurs in about 10,000 new cases every year, which makes up about 1% to 2% of lung cancer burden globally. The RET fusion was only identified in 2012, and the available treatment options were limited to multikinase inhibitors that had some anti-RET activity.

Selpercatinib gives patients the gift of time, and the antitumor activity in this study was also observed regardless of prior exposure to immune checkpoint inhibitors. The safety profile also suggests that multiple administrations is feasible in most patients. It is critical to identify these patients who are eligible for a RET inhibitor, Subbiah concludes.

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