Selpercatinib monotherapy in a Chinese patient with RET fusion/EGFR co-mutated nonsmall cell lung cancer from the Phase II LIBRETTO-321 study: a case report.,Anti-Cancer Drugs

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Selpercatinib monotherapy in a Chinese patient with RET fusion/EGFR co-mutated nonsmall cell lung cancer from the Phase II LIBRETTO-321 study: a case report.
Anti-Cancer Drugs ( IF 2.3 ) Pub Date : 2023-06-02 , DOI: 10.1097/cad.0000000000001527
Lin Wu ₁ , Ying Cheng ₂ , Dingzhi Huang ₃ , Yuping Sun ₄ , Chengzhi Zhou ₅ , Jianying Zhou ₆ , Ye Guo ₇ , Jingxin Shao ₈ , Wanli Zhang ₈ , Shun Lu ₉

Affiliation

Department II of Thoracic Medicine, Hunan Cancer Hospital
Department of Thoracic Oncology, Jilin Cancer Hospital, Changchun
Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin
Department of Oncology, Jinan Central Hospital Affiliated to Shandong University, Jinan
Respiratory Medicine Department, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou
Department of Respiratory Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou
Department of Medical Oncology, Shanghai East Hospital, Tongji University School of Medicine
Oncology, Eli Lilly and Company
Department of Medical Oncology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Rearranged during transfection (RET) fusions and epidermal growth factor receptor (EGFR) mutations are potent oncogenic drivers in patients with nonsmall cell lung cancer (NSCLC), but rarely co-exist. Concurrent RET/EGFR mutations have been reported in patients with NSCLC who develop resistance to EGFR tyrosine kinase inhibitors but are even less frequent in treatment-naïve patients. Consequently, there is no standard treatment for RET/EGFR-mutated NSCLC. We report a case of RET/EGFR mutant NSCLC successfully treated with the oral, potent, highly selective RET inhibitor selpercatinib (160 mg daily for 28-day cycles) in an ongoing phase II study in Chinese patients with NSCLC (LIBRETTO-321). The patient, a female nonsmoker, was diagnosed with de-novo left lung adenocarcinoma with neuroendocrine differentiation, and a RET fusion was detected by next-generation sequencing testing. The patient had two tumors in the pleura, a third in the subcarinal lymph node, and a nontarget tumor in the pleura. Pleural biopsy analysis confirmed a RET fusion KIF5B (K15;R12) and an EGFR exon 19 deletion. The patient achieved a partial response (PR) with selpercatinib (absence of target tumors in pleura and reduction in the size of lymph node tumor). The PR persisted for 14.7 months, with disease progression in the nontarget lesion in the pleura and a new lesion in the liver (the PR had persisted), resulting in the discontinuation of selpercatinib. The only notable adverse event was grade 3 elevated transaminase, that was effectively managed by dose reduction. These data may support the use of selpercatinib in patients with RET/EGFR co-mutated NSCLC.

更新日期：2023-06-02

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