Neoadjuvant selpercatinib for advanced medullary thyroid cancer
Yelda Jozaghi1, Mark Zafereo1, Michelle D Williams2
1Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Background:
Targeted kinase inhibitors have been increasingly utilized in the treatment of advanced medullary thyroid cancer (MTC) over the last decade. Recently, highly potent next generation selective RET inhibitors have been clinically validated, and selpercatinib was recently Food and Drug Administration (FDA)-approved for advanced MTC. The advent of highly selective, potent RET inhibitors is broadening the treatment options for patients with RET-mutated cancers.
Methods:
We report the first published case of neoadjuvant selpercatinib followed by surgery for a patient with initially unresectable, widely metastatic, RET-mutated MTC who was treated on a single patient protocol.
Results:
After greater than 50% RECIST response, the patient underwent complete surgical resection followed by selpercatinib resumption. He remains locoregionally disease-free 21 months after starting therapy with stable metastatic disease (after initial partial response); and calcitonin/CEA continue to decline.
Conclusion:
This novel treatment strategy for locoregionally advanced RET-mutated MTC warrants further study in clinical trials.
Insights
Selpercatinib, a targeted therapy, enabled surgery for advanced medullary thyroid cancer. This approach led to sustained disease control and is a promising strategy for RET-mutated MTC.
Area of Science:
- Oncology
- Pharmacology
- Genetics
Background:
- Targeted kinase inhibitors are increasingly used for advanced medullary thyroid cancer (MTC).
- Next-generation selective RET inhibitors, like selpercatinib, are now FDA-approved for advanced MTC.
- These inhibitors expand treatment options for RET-mutated cancers.
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