New Drug Brings Targeted Therapy to RET+ Lung Cancers
- New targeted medication selpercatinib (Retevmo) treats RET+ non-small cell lung cancer.
- More than 90% of patients who received the drug in a clinical trial responded.
- Responses lasted up to 20 months or more.
Genetic testing showed that the tumors had a rare mutation in a gene called RET. This RET fusion, as it's called, was helping the tumors grow.
Read More"My biggest fear was being diminished and not being able to do the things I've always loved doing. And that has not been an issue with this drug."
But the new lung and thyroid cancer drug selpercatinib (Retevmo) disables the RET mutation and stops cancer growth in more than 90 percent of the people with lung cancer who take it. Those are the results of the study, released today in the New England Journal of Medicine, that clenched the medication's accelerated FDA approval.
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"The best thing about this drug is that the response rate is so high. I personally haven't had any patients who did not respond to it," says Velcheti, who co-authored the study and has treated many patients with this drug since it first entered clinical trials.
Selpercatinib is the first targeted therapy for people whose lung or thyroid tumors have this specific gene mutation.
The Promise of Targeted Therapy
From one person to the next, lung tumors can have very different genetic profiles. A mutation in a gene called ALK may drive tumor growth in one person. The culprit may be EGFR or RET in another. Targeted medications different ones for different gene mutations disable the genes that support tumor growth.
Dr. Ronald Natale Talks About Targeted Therapy for Lung Cancer
People who have advanced lung cancer typically get a gene test of their tumor to see whether there's a targeted drug that could help them. Rutishauser was relieved when he learned his tumor was RET+ and that he was eligible for the clinical trial of selpercatinib at NYU. Otherwise, chemotherapy would have been his only treatment option.
"Once I got on the drug two pills a day I already started feeling better," Rutishauser says. "I had had some coughing before, and that seemed to get better." His first and second scans showed that the mass in his lungs and in his lymph nodes had shrunk.
Rutishauser has only been on the drug for about eight months. Some patients in the clinical trial responded to the drug for more than 20 months. Many were still responding when the researchers completed the study. Patients continue to take the medication for as long as it works.
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"It's very exciting," says Velcheti. "But, it's still not a cure. When we treat patients with these very potent RET inhibitors, they tend to develop other gene mutations that make the drugs no longer work. We are trying to understand what kinds of mutations these patients develop that we could target with other drugs."
Living His Life to the Fullest
Rutishauser says the new treatment has given him back the thing that mattered most to him: life the way he wanted to live it.
"My biggest fear was being diminished and not being able to do the things I've always loved doing. And that has not been an issue with this drug." Rutishauser plays banjo in a blue grass band, bikes 35 miles at a stretch, and loves to swim in the ocean.
"What matters most to me," he says, "is being able to live a full life and continue doing it."
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