Intracranial Response to Selpercatinib After Pralsetinib-Induced Disease Progression in Rearranged During Transfection Fusion-Positive Non-Small-Cell Lung Cancer: Case Report

RET fusion-positive NSCLC accounts for 1% to 2% of lung carcinoma cases. Although two Food and Drug Administration–approved selective RET inhibitors, pralsetinib, and selpercatinib, have revealed efficacy in managing RET fusion-positive NSCLC, this case series is unique in its focus on the intracran...

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Main Authors: Illaa Smesseim, MD, Tijmen van der Wel, MD, Sushil K. Badrising, MD, PhD
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:JTO Clinical and Research Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666364324001000
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author Illaa Smesseim, MD
Tijmen van der Wel, MD
Sushil K. Badrising, MD, PhD
author_facet Illaa Smesseim, MD
Tijmen van der Wel, MD
Sushil K. Badrising, MD, PhD
author_sort Illaa Smesseim, MD
collection DOAJ
description RET fusion-positive NSCLC accounts for 1% to 2% of lung carcinoma cases. Although two Food and Drug Administration–approved selective RET inhibitors, pralsetinib, and selpercatinib, have revealed efficacy in managing RET fusion-positive NSCLC, this case series is unique in its focus on the intracranial response to selpercatinib after disease progression during pralsetinib treatment. This report contributes to the literature by providing evidence of selpercatinib’s potential as a treatment option in such refractory cases. The patients described in both cases were diagnosed with metastatic RET fusion-positive NSCLC and developed intracranial metastases during pralsetinib treatment. After switching to selpercatinib, both exhibited significant intracranial responses. The first patient reported a reduction in brain metastasis size and maintained a response for over 1.5 years. The second patient also responded intracranially to selpercatinib but unfortunately passed away 8 months later owing to pulmonary hemorrhage, possibly linked to prior radiation treatment. These cases highlight the potential efficacy of selpercatinib in treating intracranial metastases in RET fusion-positive patients with NSCLC after pralsetinib-refractory progression. The key takeaway is that selpercatinib may offer a viable treatment option in such scenarios, although more extensive studies are needed to determine its role as a monotherapy or in combination with other treatments.
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spelling doaj-art-b85dc2fa0d424aee88a8beffee93b8fd2025-08-20T02:20:44ZengElsevierJTO Clinical and Research Reports2666-36432024-12-0151210073010.1016/j.jtocrr.2024.100730Intracranial Response to Selpercatinib After Pralsetinib-Induced Disease Progression in Rearranged During Transfection Fusion-Positive Non-Small-Cell Lung Cancer: Case ReportIllaa Smesseim, MD0Tijmen van der Wel, MD1Sushil K. Badrising, MD, PhD2Corresponding author. Address for correspondence: Illaa Smesseim, MD, Department of Thoracic Oncology, Netherlands Cancer Institute, Plesmanlaan 121 A 1066 CX, Amsterdam, The Netherlands.; Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The NetherlandsDepartment of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The NetherlandsDepartment of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The NetherlandsRET fusion-positive NSCLC accounts for 1% to 2% of lung carcinoma cases. Although two Food and Drug Administration–approved selective RET inhibitors, pralsetinib, and selpercatinib, have revealed efficacy in managing RET fusion-positive NSCLC, this case series is unique in its focus on the intracranial response to selpercatinib after disease progression during pralsetinib treatment. This report contributes to the literature by providing evidence of selpercatinib’s potential as a treatment option in such refractory cases. The patients described in both cases were diagnosed with metastatic RET fusion-positive NSCLC and developed intracranial metastases during pralsetinib treatment. After switching to selpercatinib, both exhibited significant intracranial responses. The first patient reported a reduction in brain metastasis size and maintained a response for over 1.5 years. The second patient also responded intracranially to selpercatinib but unfortunately passed away 8 months later owing to pulmonary hemorrhage, possibly linked to prior radiation treatment. These cases highlight the potential efficacy of selpercatinib in treating intracranial metastases in RET fusion-positive patients with NSCLC after pralsetinib-refractory progression. The key takeaway is that selpercatinib may offer a viable treatment option in such scenarios, although more extensive studies are needed to determine its role as a monotherapy or in combination with other treatments.http://www.sciencedirect.com/science/article/pii/S2666364324001000RETSelpercatinibNon–small-cell lung carcinomaRET fusionNSCLCCase Report
spellingShingle Illaa Smesseim, MD
Tijmen van der Wel, MD
Sushil K. Badrising, MD, PhD
Intracranial Response to Selpercatinib After Pralsetinib-Induced Disease Progression in Rearranged During Transfection Fusion-Positive Non-Small-Cell Lung Cancer: Case Report
JTO Clinical and Research Reports
RET
Selpercatinib
Non–small-cell lung carcinoma
RET fusion
NSCLC
Case Report
title Intracranial Response to Selpercatinib After Pralsetinib-Induced Disease Progression in Rearranged During Transfection Fusion-Positive Non-Small-Cell Lung Cancer: Case Report
title_full Intracranial Response to Selpercatinib After Pralsetinib-Induced Disease Progression in Rearranged During Transfection Fusion-Positive Non-Small-Cell Lung Cancer: Case Report
title_fullStr Intracranial Response to Selpercatinib After Pralsetinib-Induced Disease Progression in Rearranged During Transfection Fusion-Positive Non-Small-Cell Lung Cancer: Case Report
title_full_unstemmed Intracranial Response to Selpercatinib After Pralsetinib-Induced Disease Progression in Rearranged During Transfection Fusion-Positive Non-Small-Cell Lung Cancer: Case Report
title_short Intracranial Response to Selpercatinib After Pralsetinib-Induced Disease Progression in Rearranged During Transfection Fusion-Positive Non-Small-Cell Lung Cancer: Case Report
title_sort intracranial response to selpercatinib after pralsetinib induced disease progression in rearranged during transfection fusion positive non small cell lung cancer case report
topic RET
Selpercatinib
Non–small-cell lung carcinoma
RET fusion
NSCLC
Case Report
url http://www.sciencedirect.com/science/article/pii/S2666364324001000
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AT tijmenvanderwelmd intracranialresponsetoselpercatinibafterpralsetinibinduceddiseaseprogressioninrearrangedduringtransfectionfusionpositivenonsmallcelllungcancercasereport
AT sushilkbadrisingmdphd intracranialresponsetoselpercatinibafterpralsetinibinduceddiseaseprogressioninrearrangedduringtransfectionfusionpositivenonsmallcelllungcancercasereport