2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.12B.09 Real-World Efficacy and Toxicity Comparison Between the RET Inhibitors (RETi) Pralsetinib and Selpercatinib in Patients with Stage IV NSCLC

EP.12B.09 Real-World Efficacy and Toxicity Comparison Between the RET Inhibitors (RETi) Pralsetinib and Selpercatinib in Patients with Stage IV NSCLC

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The study compared the efficacy and toxicity of two RET inhibitors, pralsetinib and selpercatinib, in treating patients with stage IV non-small cell lung cancer (NSCLC). Both drugs, approved by the US FDA, target RET fusions, which occur in 1-2% of NSCLC patients. The aim was to assess how these drugs perform in real-world settings, given limited previous data on outcomes and adverse events.<br /><br />Key findings indicate that while pralsetinib and selpercatinib exhibited similar efficacy, they differed in their adverse event profiles. Selpercatinib had a considerably lower incidence of pneumonitis and fewer liver function test abnormalities compared to pralsetinib, which was associated with a lower incidence of creatinine elevation. This suggests that selpercatinib might be more suitable for patients with respiratory and hepatic comorbidities, while pralsetinib could be a better option for those with renal dysfunction.<br /><br />Notably, over 40% of patients on both medications required dose reductions, underscoring the need for close monitoring. Pralsetinib had a higher discontinuation rate, linked to increased cases of pneumonitis. The study suggests that treatment decisions should be tailored to the patient’s individual health characteristics.<br /><br />The retrospective analysis involved 40 patients treated at various Mayo Clinic locations, with data collected from the time of drug approvals up until February 2024. Statistical analyses, including Chi-squared tests and Kaplan-Meier estimates, were used to evaluate adverse events and median progression-free survival, respectively.<br /><br />The study concludes with a recommendation for further multi-centric prospective studies to better understand these drugs' comparative profiles. It provides an initial basis for optimizing the use of RET inhibitors in clinical practice based on patient-specific factors.

Asset Subtitle

Guilherme Sacchi de Camargo Correia

Meta Tag

Speaker Guilherme Sacchi de Camargo Correia

Topic Metastatic Non-small Cell Lung Cancer – Targeted Therapy

Keywords

RET inhibitors

pralsetinib

selpercatinib

NSCLC

stage IV lung cancer

adverse events

pneumonitis

liver function

renal dysfunction

real-world study