Selpercatinib for RET-positive non-small-cell lung cancer.

This trial was carried out to examine the effectiveness and safety of selpercatinib (Retevmo) in treating RET-positive non-small-cell lung cancer (NSCLC). The authors concluded that selpercatinib had good effectiveness and low toxicity in these patients.

NSCLC is responsible for 85% of all lung cancer diagnoses. The standard treatment is surgical removal of tumors and a combination of radiation therapy and chemotherapy.

RET mutations are genetic abnormalities that can cause some types of cancer, including NSCLC. RET-positive NSCLC is difficult to treat and often spreads to the brain. RET mutations have been found in 1-2% of patients with NSCLC. Selpercatinib is a RET kinase inhibitor and has shown effective in treating RET-positive tumors. However, the safety and effectiveness of selpercatinib in previously treated or newly diagnosed NSCLC remain under investigation.

105 patients who had been previously treated an 39 previously untreated patients were included. All patients received selpercatinib treatment. The average follow-up for this trial was 12.1 months. 

In patients who had previously received platinum-based chemotherapy, there was a response rate of 64%. The average duration of response to selpercatinib was 17.5 months. At one-year follow 66% of patients were disease progression-free. The survival without spread of disease was 16.5 months on average. 

In patients who were not previously treated, the response rate to selpercatinib was 85%. At 6-month follow-up 90% of responses were still ongoing in previously untreated patients. 11 patients had cancer spread to the brain when the study begun. 91% of these patients experienced a response within the brain. 

The most common side effects were high blood pressure (14% of patients), increased liver enzymes called ALT (10-13%), and low blood salt content (6%s). A total of 12 (2%) patients stopped selpercatinib because of side effects occurring.  

The authors found that selpercatinib had good effectiveness and low toxicity in patients with RET-positive NSCLC. 

Selpercatinib is manufactured by Eli Lilly, a sponsor of this clinical trial. This trail did not have a placebo group for control.