Skill Checkup: A 53-Year-Old Woman With Dry Cough and a Lung Lesion

John C. Leighton Jr, MD, FACP


September 01, 2022

Multitarget tyrosine kinase inhibition (cabozantinib or vandetanib) was once the initial treatment strategy for RET-rearranged NSCLC. However, when multitargeted TKIs were investigated for RET-altered NSCLC, response rates were modest and of limited duration. Toxicity could also be significant.

In 2020, the selective RET inhibitors selpercatinib and pralsetinib were approved, selpercatinib on the basis of the results of the LIBRETTO-01 study and pralsetinib on the basis of the ARROW trial. Both agents demonstrated high response rates in both treatment-naive and pretreated patients with RET fusion–positive NSCLC.

The patient began a regimen of selpercatinib 160 mg orally twice a day.


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