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普拉替尼治疗 RET 重排的晚期非小细胞肺癌(NSCLC)患者的临床证据和不良事件管理更新。

Clinical evidence and adverse event management update of patients with RET- rearranged advanced non-small-cell lung cancer (NSCLC) treated with pralsetinib.

机构信息

Medical Oncology Department, Thoracic Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

Department of Oncology, University of Torino, Ospedale San Luigi Gonzaga, Orbassano, TO, Italy.

出版信息

Crit Rev Oncol Hematol. 2024 Feb;194:104243. doi: 10.1016/j.critrevonc.2023.104243. Epub 2023 Dec 20.

Abstract

Current non-small cell lung cancer (NSCLC) management relies on genome-driven precision oncology thus shifting treatment paradigm towards biomarker-guided tumor-agnostic approaches. Recently, rearranged during transfection (RET) has been endorsed as tissue-agnostic target with sensitivity to RET inhibition. There are currently two selective RET tyrosine kinase inhibitors, pralsetinib and selpercatinib. The recent introduction of pralsetinib in the treatment algorithm of RET-rearranged tumor along with the mounting clinical evidence of pralsetinib durable activity from both randomized and observational studies holds the potential to disclose new avenues in the management of RET fusion positive NSCLC patients. Our narrative review aims to discuss the available clinical evidence on pralsetinib efficacy, particularly on brain metastases, and tolerability profile. In addition, our work explores the relevance of detecting RET fusions upfront in the disease history of patients with NSCLC.

摘要

目前,非小细胞肺癌(NSCLC)的治疗依赖于基于基因组的精准肿瘤学,从而将治疗模式转向基于生物标志物的肿瘤不可知方法。最近,转染过程中重排(RET)被认为是一种组织不可知的靶点,对 RET 抑制敏感。目前有两种选择性 RET 酪氨酸激酶抑制剂,普拉替尼和塞尔帕替尼。普拉替尼最近被引入到 RET 重排肿瘤的治疗方案中,并且来自随机和观察性研究的普拉替尼持久活性的临床证据不断增加,这有可能为治疗 RET 融合阳性 NSCLC 患者开辟新的途径。我们的叙述性综述旨在讨论普拉替尼疗效的现有临床证据,特别是对脑转移的疗效和耐受性特征。此外,我们的工作还探讨了在 NSCLC 患者的疾病史中提前检测 RET 融合的相关性。

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