Lu S, Cheng Y, Huang D, Sun Y, Wu L, Zhou C, Guo Y, Shao J, Zhang W, Zhou J. Efficacy and safety of selpercatinib in Chinese patients with advanced
RET fusion-positive non-small-cell lung cancer: a phase II clinical trial (LIBRETTO-321).
Ther Adv Med Oncol 2022;
14:17588359221105020. [PMID:
35923928 PMCID:
PMC9340421 DOI:
10.1177/17588359221105020]
[Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/17/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction:
Oncogenic alterations in RET occur in 1–2% of non-small-cell
lung cancers (NSCLCs). The efficacy and safety of the first-in-class, highly
selective, and potent RET inhibitor selpercatinib in Chinese patients with
RET fusion-positive NSCLC remains unknown.
Methods:
In this open-label, multicenter, phase II study (NCT04280081), patients with
advanced RET-altered solid tumors received selpercatinib
(160 mg orally twice daily) in a 28-day cycle. The primary endpoint was
independent review committee (IRC)-assessed objective response rate (ORR;
Response Evaluation Criteria in Solid Tumors v1.1). Secondary endpoints
included duration of response, central nervous system (CNS) response, and
safety. Efficacy against NSCLC was assessed in the primary analysis set
(PAS; centrally confirmed RET status) and in all enrolled
patients with NSCLC.
Results:
Of 77 enrolled patients, 47 had RET fusion-positive NSCLC.
After 9.7 months of median follow-up, IRC-assessed ORR in the PAS
(n = 26) was 69.2% [95% confidence interval (CI),
48.2–85.7] and 94.4% of responses were ongoing; the ORR was 87.5% and 61.1%
in treatment-naïve and pre-treated patients, respectively. IRC-assessed ORR
in all patients with NSCLC (n = 47) was 66.0% (95% CI,
50.7–79.1). Among five patients with measurable CNS metastases at baseline,
four (80%) achieved an IRC-assessed intracranial response. In the safety
population (n = 77), most treatment-emergent adverse events
(TEAEs) were grade 1 or 2. The most common grade ⩾3 TEAE was hypertension
(19.5%). Three (3.9%) patients discontinued therapy due to treatment-related
AEs; no deaths occurred due to treatment-related AEs.
Conclusion:
Selpercatinib, with potent and durable antitumor activity including
intracranial activity, was well tolerated in Chinese patients with
RET fusion-positive NSCLC, consistent with LIBRETTO-001
(ClinicalTrials.gov: NCT04280081).
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