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

John C. Leighton Jr, MD, FACP


September 01, 2022

NCCN guidelines recommend systemic therapy after first-line failure of a RET-specific TKI for RET rearrangement–positive adenocarcinoma. If there are no contraindications to PD-1 or PD-L1 inhibitors, preferred category 1 regimens for second-line treatment are pembrolizumab/carboplatin/pemetrexed or pembrolizumab/cisplatin/pemetrexed.

Other recommended category 1 second-line regimens are atezolizumab/carboplatin/paclitaxel/bevacizumab or nivolumab/ipilimumab/pemetrexed/(carboplatin or cisplatin).

After treatment failure with a RET-specific TKI, another drug in the same class may not be used in subsequent therapy.

Editor's Note: Skill Checkups are wholly fictional or fictionalized clinical scenarios intended to provide evidence-based educational takeaways.

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