Successful treatment with selpercatinib after pralsetinib-related pneumonitis and intracranial failure in a patient with RET-rearranged nonsmall cell lung cancer

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc..

Pralsetinib and selpercatinib are two highly potent and selective rearranged during transfection (RET) inhibitors that substantially improved the clinical outcome of patients with RET-rearranged non-small cell lung cancer. Treatment with one RET inhibitor after failure of the other is generally not recommended because of cross-resistance mechanisms. We report the case of a patient affected by metastatic RET-rearranged non-small cell lung cancer who experienced long-lasting disease control with pralsetinib. After 13 months from treatment start, the patient developed recurrent drug-related pneumonitis, requiring temporary interruptions and dose reductions and eventually failing to control the disease. Selpercatinib was then started as an off-label treatment, allowing both clinical and radiological intracranial disease control. Selpercatinib was well-tolerated at full dosage, and no pulmonary event occurred. In our case report, after pralsetinib dose reduction due to pulmonary toxicity, the therapeutic switch to selpercatinib allowed the patient to receive a full-dose treatment, eventually restoring disease control. Our case report and a few literature data suggest that switching from pralsetinib to selpercatinib may represent a therapeutic opportunity, especially for patients with brain metastases.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

Anti-cancer drugs - (2024) vom: 08. März

Sprache:

Englisch

Beteiligte Personen:

Cognigni, Valeria [VerfasserIn]
Giudice, Giulia Claire [VerfasserIn]
Bozzetti, Francesca [VerfasserIn]
Milanese, Gianluca [VerfasserIn]
Moschini, Ilaria [VerfasserIn]
Casali, Miriam [VerfasserIn]
Mazzaschi, Giulia [VerfasserIn]
Tiseo, Marcello [VerfasserIn]

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Date Revised 16.04.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1097/CAD.0000000000001590

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369429036