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Data from Intracranial Efficacy of Selpercatinib in RET Fusion-Positive Non–Small Cell Lung Cancers on the LIBRETTO-001 Trial

Authors :
Alexander Drilon
Suhyun Kang
Xin Huang
Jennifer F. Kherani
Edward Y. Zhu
Christian Rolfo
Oliver Gautschi
Benjamin Besse
Haruko Daga
Keunchil Park
Lyudmila Bazhenova
Yu Jung Kim
Jared Weiss
Caroline E. McCoach
Herbert H. Loong
Byoung Chul Cho
Dwight H. Owen
Daniel S.W. Tan
Geoffrey R. Oxnard
Justin F. Gainor
Vivek Subbiah
Publication Year :
2023
Publisher :
American Association for Cancer Research (AACR), 2023.

Abstract

Purpose:We report the intracranial efficacy of selpercatinib, a highly potent and selective RET inhibitor, approved in the United States for RET fusion-positive non–small cell lung cancers (NSCLC).Patients and Methods:In the global phase 1/2 LIBRETTO-001 trial (NCT03157128) in advanced RET-altered solid tumors, selpercatinib was dosed orally (160 mg twice every day) in 28-day cycles. Patients with baseline intracranial metastases had MRI/CT scans every 8 weeks for 1 year (12 weeks thereafter). In this pre-planned analysis of patients with RET fusion-positive NSCLC with baseline intracranial metastases, the primary endpoint was independently assessed intracranial objective response rate (ORR) per RECIST 1.1. Secondary endpoints included intracranial disease control rate, intracranial duration of response, and intracranial progression-free survival (PFS) independently reviewed.Results:Eighty patients with NSCLC had brain metastases at baseline. Patients were heavily pretreated (median = 2 systemic therapies, range = 0–10); 56% of patients received ≥1 course of intracranial radiation (14% whole brain radiotherapy, 45% stereotactic radiosurgery). Among 22 patients with measurable intracranial disease at baseline, intracranial ORR was 82% [95% confidence interval (CI), 60–95], including 23% with complete responses. Among all intracranial responders (measurable and nonmeasurable, n = 38), median duration of intracranial response was not reached (95% CI, 9.3–NE) at a median duration of follow-up of 9.5 months (IQR = 5.7, 12.0). At 12 months, 55% of intracranial responses were ongoing. In all 80 patients, median intracranial PFS was 13.7 months (95% CI, 10.9–NE) at a median duration of follow-up of 11.0 months (IQR = 7.4, 16.5). No new safety signals were revealed in patients with brain metastases compared with the full NSCLC trial population.Conclusions:Selpercatinib has robust and durable intracranial efficacy in patients with RET fusion-positive NSCLC.

Details

Database :
OpenAIRE
Accession number :
edsair.doi.dedup.....742dc512893dff922fa531405d749bb5
Full Text :
https://doi.org/10.1158/1078-0432.c.6530655.v1