RET targeted therapy Retevmo opens era of precision medicine

Lands in Korea as a treatment for NSCLC and thyroid cancer

Shows CNS ORR of 82% …. 23% of which achieve complete response

“Takes around a month for diagnosis…cancer immunotherapy can be used first”

Lilly Korea’s RET targeted therapy Retevmo(selpercatinib) has landed in Korea.

 

The drug is expected to become a new treatment option in RET fusion-positive patients with non-small-cell lung cancer and thyroid cancer.

 

Lilly Korea held an online press conference to celebrate the approval of Retevmo on the 25th.

 

Professor Min Hee Hong of Oncology at Yonsei Cancer Center and Professor Won Gu Kim of Endocrinology and Metabolism at Asan Medical Center attended the virtual event to explain the significance of Retevmo’s approval.

 

Retevmo was approved by the Ministry of Food and Drug Safety in March last year as a treatment for RET fusion-positive NSCLC and thyroid cancer patients.

 

More specifically, the drug is indicated for the treatment of▲ adult patients with metastatic RET fusion-positive non-small cell lung cancer (NSCLC); ▲adults and pediatric patients 12 years of age or older with advanced or metastatic RET-mutated medullary thyroid cancer who require systemic therapy; and ▲ adult patients who are refractory to radioactive iodine therapy and who have prior sorafenib and/or lenvatinib treatment, with advanced or metastatic RET-fusion benign thyroid cancer who require systemic therapy.

 

At the press conference, Professor Hong said, “Lung cancer patients with RET mutations are twice more likely to experience CNS metastasis, but had to be treated with chemotherapy, which is less effective and more prone to toxicity due to the lack of RET targeted therapies.

 

Retevmo demonstrated significant response in the LIBRETTO-001 trial, as well as an 82% ORR in patients with CNS metastasis.

 

23% of these patients achieved complete response.” Kim added, “Although the survival rate for thyroid cancer is known to be high patients with RET point mutated medullary thyroid cancer have a poor prognosis and low survival rate.

 

Also, patients with thyroid cancer who are refractory to radioactive iodine therapy have a low survival rate and life expectancy.

 

Retevmo has shown a 79% and 69% ORR in the abovementioned patient groups, opening a new era of precision medicine.” RET mutations occur in 2 to 6 % of all NSCLC cases and are more often found in adenocarcinomas and younger patients under 60 years of age and non-smokers.

 

In NSCLC, RET fusions occur more than RET mutations.

 

In thyroid cancer, RET fusions are reported in up to 40% of the cases.

 

RET fusions can be identified through rest such as NGS, FISH, RT-PCR, etc.

 

Among the tests, NGS is known to be the most effective diagnostic method for identifying RET fusions.

 

However, it takes around one month to receive results after NGS testing, and as ‘Keytruda,’ a reimbursed immunotherapy option already exists for NSCLC in the first line, it is highly likely that Retevmo will not be selected as a first-line treatment in these patients.

 

Professor Hong said, “As RET fusion is not a common mutation, we cannot idly just wait for the test results, therefore it is likely that we will use immunotherapies first.

 

However, using immunotherapies before Retevmo may reduce the response rate to Retevmo, this is why it is important for us to receive the NGS results as quickly as possible.”