Cargando…

Case Report: Complete pathologic response to neoadjuvant selpercatinib in a patient with resectable early-stage RET fusion-positive non-small cell lung cancer

The LIBRETTO-001 trial demonstrated the activity of the selective rearrangement during transfection (RET) inhibitor selpercatinib in advanced RET fusion-positive non-small cell lung cancer (NSCLC) and resulted in the drug’s approval for this indication. A cohort that included neoadjuvant and adjuvan...

Descripción completa

Detalles Bibliográficos
Autores principales: Goldman, Jonathan W., Sholl, Lynette M., Dacic, Sanja, Fishbein, Michael C., Murciano-Goroff, Yonina R., Rajaram, Ravi, Szymczak, Sylwia, Szpurka, Anna M., Chao, Bo H., Drilon, Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10232990/
https://www.ncbi.nlm.nih.gov/pubmed/37274265
http://dx.doi.org/10.3389/fonc.2023.1178313
_version_ 1785052128841039872
author Goldman, Jonathan W.
Sholl, Lynette M.
Dacic, Sanja
Fishbein, Michael C.
Murciano-Goroff, Yonina R.
Rajaram, Ravi
Szymczak, Sylwia
Szpurka, Anna M.
Chao, Bo H.
Drilon, Alexander
author_facet Goldman, Jonathan W.
Sholl, Lynette M.
Dacic, Sanja
Fishbein, Michael C.
Murciano-Goroff, Yonina R.
Rajaram, Ravi
Szymczak, Sylwia
Szpurka, Anna M.
Chao, Bo H.
Drilon, Alexander
author_sort Goldman, Jonathan W.
collection PubMed
description The LIBRETTO-001 trial demonstrated the activity of the selective rearrangement during transfection (RET) inhibitor selpercatinib in advanced RET fusion-positive non-small cell lung cancer (NSCLC) and resulted in the drug’s approval for this indication. A cohort that included neoadjuvant and adjuvant selpercatinib was opened on LIBRETTO-001 for early-stage RET fusion-positive NSCLC with the primary endpoint of major pathologic response. A patient with a stage IB (cT2aN0M0) KIF5B-RET fusion-positive NSCLC received 8 weeks of neoadjuvant selpercatinib at 160 mg twice daily followed by surgery. While moderate regression in the primary tumor (stable disease, Response Evaluation Criteria in Solid Tumors (RECIST) guidelines version 1.1) was observed radiologically, assessment via an Independent Pathologic Review Committee revealed a pathologic complete response (0% viable tumor). This consensus assessment by three independent pathologists was aided by RET fluorescence in situ hybridization testing of a reactive pneumocyte proliferation showing no rearrangement. Neoadjuvant selpercatinib was well-tolerated with only low-grade treatment-emergent adverse events. The activity of prospective preoperative selpercatinib in this case establishes proof of concept of the potential utility of RET inhibitor therapy in early-stage RET fusion-positive NSCLC.
format Online
Article
Text
id pubmed-10232990
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-102329902023-06-02 Case Report: Complete pathologic response to neoadjuvant selpercatinib in a patient with resectable early-stage RET fusion-positive non-small cell lung cancer Goldman, Jonathan W. Sholl, Lynette M. Dacic, Sanja Fishbein, Michael C. Murciano-Goroff, Yonina R. Rajaram, Ravi Szymczak, Sylwia Szpurka, Anna M. Chao, Bo H. Drilon, Alexander Front Oncol Oncology The LIBRETTO-001 trial demonstrated the activity of the selective rearrangement during transfection (RET) inhibitor selpercatinib in advanced RET fusion-positive non-small cell lung cancer (NSCLC) and resulted in the drug’s approval for this indication. A cohort that included neoadjuvant and adjuvant selpercatinib was opened on LIBRETTO-001 for early-stage RET fusion-positive NSCLC with the primary endpoint of major pathologic response. A patient with a stage IB (cT2aN0M0) KIF5B-RET fusion-positive NSCLC received 8 weeks of neoadjuvant selpercatinib at 160 mg twice daily followed by surgery. While moderate regression in the primary tumor (stable disease, Response Evaluation Criteria in Solid Tumors (RECIST) guidelines version 1.1) was observed radiologically, assessment via an Independent Pathologic Review Committee revealed a pathologic complete response (0% viable tumor). This consensus assessment by three independent pathologists was aided by RET fluorescence in situ hybridization testing of a reactive pneumocyte proliferation showing no rearrangement. Neoadjuvant selpercatinib was well-tolerated with only low-grade treatment-emergent adverse events. The activity of prospective preoperative selpercatinib in this case establishes proof of concept of the potential utility of RET inhibitor therapy in early-stage RET fusion-positive NSCLC. Frontiers Media S.A. 2023-05-18 /pmc/articles/PMC10232990/ /pubmed/37274265 http://dx.doi.org/10.3389/fonc.2023.1178313 Text en Copyright © 2023 Goldman, Sholl, Dacic, Fishbein, Murciano-Goroff, Rajaram, Szymczak, Szpurka, Chao and Drilon https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Goldman, Jonathan W.
Sholl, Lynette M.
Dacic, Sanja
Fishbein, Michael C.
Murciano-Goroff, Yonina R.
Rajaram, Ravi
Szymczak, Sylwia
Szpurka, Anna M.
Chao, Bo H.
Drilon, Alexander
Case Report: Complete pathologic response to neoadjuvant selpercatinib in a patient with resectable early-stage RET fusion-positive non-small cell lung cancer
title Case Report: Complete pathologic response to neoadjuvant selpercatinib in a patient with resectable early-stage RET fusion-positive non-small cell lung cancer
title_full Case Report: Complete pathologic response to neoadjuvant selpercatinib in a patient with resectable early-stage RET fusion-positive non-small cell lung cancer
title_fullStr Case Report: Complete pathologic response to neoadjuvant selpercatinib in a patient with resectable early-stage RET fusion-positive non-small cell lung cancer
title_full_unstemmed Case Report: Complete pathologic response to neoadjuvant selpercatinib in a patient with resectable early-stage RET fusion-positive non-small cell lung cancer
title_short Case Report: Complete pathologic response to neoadjuvant selpercatinib in a patient with resectable early-stage RET fusion-positive non-small cell lung cancer
title_sort case report: complete pathologic response to neoadjuvant selpercatinib in a patient with resectable early-stage ret fusion-positive non-small cell lung cancer
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10232990/
https://www.ncbi.nlm.nih.gov/pubmed/37274265
http://dx.doi.org/10.3389/fonc.2023.1178313
work_keys_str_mv AT goldmanjonathanw casereportcompletepathologicresponsetoneoadjuvantselpercatinibinapatientwithresectableearlystageretfusionpositivenonsmallcelllungcancer
AT sholllynettem casereportcompletepathologicresponsetoneoadjuvantselpercatinibinapatientwithresectableearlystageretfusionpositivenonsmallcelllungcancer
AT dacicsanja casereportcompletepathologicresponsetoneoadjuvantselpercatinibinapatientwithresectableearlystageretfusionpositivenonsmallcelllungcancer
AT fishbeinmichaelc casereportcompletepathologicresponsetoneoadjuvantselpercatinibinapatientwithresectableearlystageretfusionpositivenonsmallcelllungcancer
AT murcianogoroffyoninar casereportcompletepathologicresponsetoneoadjuvantselpercatinibinapatientwithresectableearlystageretfusionpositivenonsmallcelllungcancer
AT rajaramravi casereportcompletepathologicresponsetoneoadjuvantselpercatinibinapatientwithresectableearlystageretfusionpositivenonsmallcelllungcancer
AT szymczaksylwia casereportcompletepathologicresponsetoneoadjuvantselpercatinibinapatientwithresectableearlystageretfusionpositivenonsmallcelllungcancer
AT szpurkaannam casereportcompletepathologicresponsetoneoadjuvantselpercatinibinapatientwithresectableearlystageretfusionpositivenonsmallcelllungcancer
AT chaoboh casereportcompletepathologicresponsetoneoadjuvantselpercatinibinapatientwithresectableearlystageretfusionpositivenonsmallcelllungcancer
AT drilonalexander casereportcompletepathologicresponsetoneoadjuvantselpercatinibinapatientwithresectableearlystageretfusionpositivenonsmallcelllungcancer