Drilon, A., Oxnard, G. R., Tan, D. S. W., Loong, H. H. F., Johnson, M., Gainor, J., McCoach, C. E., Gautschi, O., Besse, B., Cho, B. C., Peled, N., Weiss, J., Kim, Y. -J., Ohe, Y., Nishio, M., Park, K., Patel, J., Seto, T., Sakamoto, T., Rosen, E., Shah, M. H., Barlesi, F., Cassier, P. A., Bazhenova, L., De Braud, F., Garralda, E., Velcheti, V., Satouchi, M., Ohashi, K., Pennell, N. A., Reckamp, K. L., Dy, G. K., Wolf, J., Solomon, B., Falchook, G., Ebata, K., Nguyen, M., Nair, B., Zhu, E. Y., Yang, L., Huang, X., Olek, E., Rothenberg, S. M., Goto, K. and Subbiah, V. (2020). Efficacy of Selpercatinib in RET Fusion-Positive Non-Small-Cell Lung Cancer. N. Engl. J. Med., 383 (9). S. 813 - 825. WALTHAM: MASSACHUSETTS MEDICAL SOC. ISSN 1533-4406

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Abstract

BACKGROUND RET fusions are oncogenic drivers in 1 to 2% of non-small-cell lung cancers (NSCLCs). In patients with RET fusion-positive NSCLC, the efficacy and safety of selective RET inhibition are unknown. METHODS We enrolled patients with advanced RET fusion-positive NSCLC who had previously received platinum-based chemotherapy and those who were previously untreated separately in a phase 1-2 trial of selpercatinib. The primary end point was an objective response (a complete or partial response) as determined by an independent review committee. Secondary end points included the duration of response, progression-free survival, and safety. RESULTS In the first 105 consecutively enrolled patients with RET fusion-positive NSCLC who had previously received at least platinum-based chemotherapy, the percentage with an objective response was 64% (95% confidence interval [CI], 54 to 73). The median duration of response was 17.5 months (95% CI, 12.0 to could not be evaluated), and 63% of the responses were ongoing at a median follow-up of 12.1 months. Among 39 previously untreated patients, the percentage with an objective response was 85% (95% CI, 70 to 94), and 90% of the responses were ongoing at 6 months. Among 11 patients with measurable central nervous system metastasis at enrollment, the percentage with an objective intracranial response was 91% (95% CI, 59 to 100). The most common adverse events of grade 3 or higher were hypertension (in 14% of the patients), an increased alanine aminotransferase level (in 12%), an increased aspartate aminotransferase level (in 10%), hyponatremia (in 6%), and lymphopenia (in 6%). A total of 12 of 531 patients (2%) discontinued selpercatinib because of a drug-related adverse event. CONCLUSIONS Selpercatinib had durable efficacy, including intracranial activity, with mainly low-grade toxic effects in patients with RET fusion-positive NSCLC who had previously received platinum-based chemotherapy and those who were previously untreated.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Drilon, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oxnard, G. R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tan, D. S. W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Loong, H. H. F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Johnson, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gainor, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
McCoach, C. E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gautschi, O.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Besse, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cho, B. C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Peled, N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weiss, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kim, Y. -J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ohe, Y.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nishio, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Park, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Patel, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seto, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sakamoto, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosen, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shah, M. H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barlesi, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cassier, P. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bazhenova, L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Braud, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Garralda, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Velcheti, V.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Satouchi, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ohashi, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pennell, N. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reckamp, K. L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dy, G. K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wolf, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Solomon, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Falchook, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ebata, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nguyen, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nair, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zhu, E. Y.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yang, L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Huang, X.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Olek, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rothenberg, S. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goto, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Subbiah, V.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-322548
DOI: 10.1056/NEJMoa2005653
Journal or Publication Title: N. Engl. J. Med.
Volume: 383
Number: 9
Page Range: S. 813 - 825
Date: 2020
Publisher: MASSACHUSETTS MEDICAL SOC
Place of Publication: WALTHAM
ISSN: 1533-4406
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
TARGETING RET; OPEN-LABEL; LAROTRECTINIB; PHASE-2Multiple languages
Medicine, General & InternalMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/32254

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