National Comprehensive Cancer Network guidelines for RET-rearranged positive NSCLC advise that for RET rearrangement discovered before first-line systemic therapy, the recommended treatment is selpercatinib or pralsetinib. However, it is important to note that acquired resistance may limit this strategy's long-term efficacy.
Vandetanib and cabozantinib are considered category 2B therapy. If the disease progresses after first-line treatment, guidelines recommend either selpercatinib or pralsetinib as well as systemic therapy for NSCLC.
If the RET rearrangement is discovered during the first line of chemotherapy, the same guidelines recommend completing a course of systemic therapy, including maintenance therapy, or interrupting therapy followed by selpercatinib or pralsetinib. In appropriate cases, patients may be started on cabozantinib or vandetanib.
Learn more about treatment for NSCLC with RET fusion.
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Cite this: Maurie Markman. Fast Five Quiz: Non–Small Cell Lung Cancer (NSCLC) and RET Mutation - Medscape - Aug 22, 2022.