New Biological Insights and Recent Therapeutic Advances in the Management of Lung Cancer: A Clinical Investigator Think Tank
A patient with a RET-rearranged tumor identified through multiplex testing receives cabozantinib
2:31 minutes.
TRANSCRIPTION:
DR KRIS: Yes. So again, we do multiplex testing and we are able to find abnormalities in all the relevant genes. We do have a clinical trial for folks with RET rearrangements as well. As it turned out, this patient had multiplex testing sent, but this patient was interested in immune therapy trial. So she went on a clinical trial of MPDL3280A. DR LOVE: Is that a PD-L1 agent? DR KRIS: It’s an anti-PD-L1 agent. And she did not respond, actually. And then in the course of that clinical trial, her RET result came back. And she was started on cabozantinib and since then she has had, officially she’s had stable disease, but with a very excellent tolerability and living an essentially normal life. There is a broader experience within that clinical trial, where there are a lot of objective remissions. There are also reports of responses with vandetanib and reports of responses with sunitinib, actually, as well. DR LOVE: And these are durable responses? DR KRIS: They are. A lot of people, I think like many of the experiences here, some people progress right through it, some people have stable disease, some people have long, durable responses with these targeted agents. And that’s our conundrum nowadays: How do we figure that out? DR LOVE: And what’s the incidence of RET rearrangements? DR KRIS: It’s interesting. I’m going through some of the data for a national group that many of us here in the room are part of. It turns out we see more RET than we do see ROS1. It’s like — actually, in our little group, it’s almost 3 times as many RET mutations as ROS1 rearrangements — RET — not mutations. Rearrangements of RET and ROS1 rearrangements. So it’s rare, but it’s there. And you find it in the next-gen testing. And it’s actionable either on a clinical trial or in some of the available drugs that are out there. |