Lancet oncol: Pralsetinib is expected to be used in the treatment of RET fusion-positive NSCLC

Carcinogenic changes of RET have been found in many types of tumors, including 1-2% of non-small cell lung cancer ( NSCLC )
.
The purpose of this study was to evaluate the safety, tolerability and anti-tumor activity of pratinib (Pralsetinib, a highly effective, oral, and selective RET inhibitor) in patients with RET fusion-positive NSCLC

The ARROW trial is a multi-cohort, open-label Phase 1/2 study conducted in 71 locations in 13 countries, recruiting patients with locally advanced or metastatic solid tumors over 18 years of age, including NSCLC with RET fusion-positive NSCLC Patient
.
In the second phase, the patient is treated with 400 mg of pratinib orally every day until the disease progresses, intolerance, withdrawal from the trial, or the investigator's decision

Treatment response

From March 17, 2017 to May 22, 2020, a total of 233 NSCLC patients carrying the RET fusion gene were recruited, of which 92 had previously received platinum-based chemotherapy, and 29 were on July 11, 2019.
Have not received pratinib treatment recently; 87 previously treated patients and 27 newly-treated patients had baseline measurable lesions that were centrally judged
.

Adverse events

Of 87 patients who had previously received platinum-based chemotherapy, 53 (61%) and 19 (70%) of 27-naïve patients achieved remission, including 3 complete remissions
.
Among the 233 NSCLC patients with RET fusion mutations, the most common adverse events of grade 3 and above requiring emergency treatment were neutropenia (18%), hypertension (11%) and anemia (10%) ; No treatment-related deaths

In conclusion, pratinib is a new, well-tolerated and promising oral treatment option for NSCLC patients with RET fusion-positive

Justin F Gainor, et al.