Clinical development of RET inhibitors in RET-rearranged non-small cell lung cancer: Update
1IQVIA, Prague, Czech Republic.
Abstract:
Precision oncology is now the evidence-based standard of care for the management of many advanced non-small cell lung cancers (NSCLC). Notably, new molecular profiling technologies have permitted dynamic growth in the identification of actionable driver oncogenes including RET rearrangements. RET oncogenes cannot be adequately detected by immunohistochemistry, although fluorescence in situ hybridization, reverse transcriptase polymerase chain reaction and next-generation sequencing are complementary diagnostic tools. In the clinical setting, the benefit of the most developed RET inhibitors, i.e., cabozantinb, vandetanib and lenvatinb, in terms of response and median progressionfree survival has been demonstrated. The absence of striking clinical results of RET inhibitors underscores the clear need for development of more selective and potent RET inhibitors. This paper reviews the clinical data available on RET inhibitors in RET-associated NSCLC.
Insights
Precision oncology, standard for advanced non-small cell lung cancer (NSCLC), identifies actionable RET rearrangements. While current RET inhibitors show benefit, more potent drugs are needed for RET-associated NSCLC.
Area of Science:
- Oncology
- Molecular Diagnostics
- Pharmacology
Background:
- Precision oncology is the standard for advanced non-small cell lung cancer (NSCLC).
- RET rearrangements are actionable driver oncogenes identified through molecular profiling.
- Immunohistochemistry is insufficient for detecting RET alterations; FISH, RT-PCR, and NGS are complementary.
Purpose of the Study:
- To review clinical data on RET inhibitors in RET-associated NSCLC.
- To highlight the need for improved RET inhibitors.
Main Methods:
- Review of clinical data on RET inhibitors.
- Analysis of diagnostic tools for RET rearrangements.
Main Results:
- Existing RET inhibitors (cabozantinib, vandetanib, lenvatinib) demonstrate clinical benefits in response and progression-free survival for NSCLC.
- Clinical results with current RET inhibitors are not striking, indicating a need for enhanced therapies.
Conclusions:
- RET rearrangements are important targets in NSCLC management.
- Development of more selective and potent RET inhibitors is crucial for improving patient outcomes in RET-associated NSCLC.
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