SELPERCATINIB, a targeted RET kinase inhibitor, has demonstrated continued efficacy in treating RET fusion-positive non–small cell lung cancer (NSCLC) even after disease progression. A new analysis from the LIBRETTO-001 trial suggests that continuing selpercatinib beyond investigator-assessed progression can benefit patients, especially those with limited progression.
In a cohort of 80 patients with confirmed disease progression, those who continued selpercatinib showed a median treatment duration of 5.9 months post-progression. Notably, patients with oligoprogression, defined as progression at a few sites, benefited the most, with a median treatment duration of 9.8 months. This benefit was consistent in both central nervous system (CNS) and extracranial progression.
The study also highlighted the positive impact of local radiotherapy, with 41.3% of patients receiving radiotherapy after progression, which extended the time on treatment across all subgroups. In particular, patients with CNS-only progression had a median postprogression treatment duration of 7.5 months, while those with extracranial progression had 6.4 months.
This analysis supports the feasibility of continuing selpercatinib in patients with limited progression, including those with CNS involvement, offering a promising strategy for maintaining disease control and extending survival. This approach may provide clinicians with an additional therapeutic option for managing RET fusion-positive NSCLC beyond initial progression.
Reference: Besse B et al. Selpercatinib Treatment Beyond Progression in RET Fusion–Positive Non–Small Cell Lung Cancer. JCO OA. 2024;1.
Anaya Malik | AMJ
