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Selpercatinib in RET fusion-positive non-small-cell lung cancer (SIREN): a retrospective analysis of patients treated through an access program

  • Oliver Illini*
  • , Maximilian Johannes Hochmair
  • , Hannah Fabikan
  • , Christoph Weinlinger
  • , Amanda Tufman
  • , Aurélie Swalduz
  • , Kristina Lamberg
  • , Sayed M. S. Hashemi
  • , Florian Huemer
  • , Anders Vikström
  • , Martin Wermke
  • , Gudrun Absenger
  • , Alfredo Addeo
  • , Shantanu Banerji
  • , Antonio Calles
  • , Stephen Clarke
  • , Massimo di Maio
  • , Alice Durand
  • , Michaël Duruisseaux
  • , Malinda Itchins
  • Okko-Sakari Kääränien, Florian Krenn, Eckart Laack, Adrianus Johannes de Langen, Katja Mohorcic, Georg Pall, Antonio Passaro, Gerald Prager, Achim Rittmeyer, Jeffrey Rothenstein, Michael Schumacher, Ewald Wöll, Arschang Valipour
*Corresponding author for this work
  • Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Brünner Strasse 68, Vienna, 1210, Austria
  • Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
  • Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
  • University Hospital Munich
  • Centre Léon Bérard
  • University Hospital
  • Ludwig Boltzmann Institute
  • Linköping University
  • Technische Universität Dresden
  • Medical University of Graz
  • University of Geneva
  • University of Manitoba
  • Complutense University
  • Royal North Shore Hospital
  • University of Turin
  • Hôpital Louis Pradel
  • Universite Claude Bernard Lyon 1
  • Kuopio University Hospital
  • LKH Hochsteiermark – Standort Leoben, Austria
  • Studiengesellschaft Hämato-Onkologie Hamburg, Hamburg, Germany
  • Netherlands Cancer Institute
  • University of Ljubljana
  • Innsbruck Medical University
  • IRCCS Istituto Europeo di Oncologia - Milano
  • Department of Medicine I, Comprehensive Cancer Center Vienna, Vienna, Austria
  • LKI Lungenfachklinik Immenhausen, Department of Thoracic Oncology, Immenhausen, Germany
  • Queen's University Kingston
  • Department of Pneumology, Ordensklinikum Elisabethinen Linz, Linz, Austria
  • Department Internal Medicine, St. Vinzenz Krankenhaus Betriebs GmbH, Sanatoriumstr. 43, Zams, 6511, Austria
  • Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Introduction: Rearranged during transfection (RET) gene fusions are rare genetic drivers in non-small cell lung cancer (NSCLC). Selective RET-inhibitors such as selpercatinib have shown therapeutic activity in early clinical trials; however, their efficacy in the real-world setting is unknown. Methods: A retrospective efficacy and safety analysis was performed on data from RET fusion-positive NSCLC patients who participated in a selpercatinib access program (named patient protocol) between August 2019 and January 2021. Results: Data from 50 patients with RET fusion-positive advanced NSCLC treated with selpercatinib at 27 centers in 12 countries was analyzed. Most patients were Non-Asian (90%), female (60%), never-smokers (74%), with a median age of 65 years (range, 38–89). 32% of the patients had known brain metastasis at the time of selpercatinib treatment. Overall, 13 patients were treatment-naïve, while 37 were pretreated with a median of three lines of therapy (range, 1–8). The objective response rate (ORR) was 68% [95% confidence interval (CI), 53–81] in the overall population. The disease control rate was 92%. The median progression-free survival was 15.6 months (95% CI, 8.8–22.4) after a median follow-up of 9 months. In patients with measurable brain metastases (n = 8) intracranial ORR reached 100%. In total, 88% of patients experienced treatment-related adverse events (TRAEs), a large majority of them being grade 1 or 2. The most common grade ⩾ 3 TRAEs were increased liver enzyme levels (in 10% of patients), prolonged QTc time (4%), abdominal pain (4%), hypertension (4%), and fatigue/asthenia (4%). None of patients discontinued selpercatinib treatment for safety reasons. No new safety concerns were observed, nor where there any treatment-related death. Conclusions: In this real-world setting, the selective RET-inhibitor selpercatinib demonstrated durable systemic and intracranial antitumor activity in RET fusion-positive NSCLC and was well tolerated.
Original languageEnglish
JournalTherapeutic advances in medical oncology
Volume13
DOIs
Publication statusPublished - 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

Keywords

  • RET gene fusions
  • non-small cell lung cancer (NSCLC)
  • real-world data
  • selpercatinib
  • targeted therapy
  • tyrosine kinase inhibitor (TKI)

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