Safety and efficacy of pralsetinib in RET fusion-positive non-small-cell lung cancer including as first-line therapy: update from the ARROW trial
Background - RET fusions are present in 1%-2% of non-small-cell lung cancer (NSCLC). Pralsetinib, a highly potent, oral, central nervous system-penetrant, selective RET inhibitor, previously demonstrated clinical activity in patients with RET fusion-positive NSCLC in the phase I/II ARROW study, incl...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
13 August 2022
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| In: |
Annals of oncology
Year: 2022, Volume: 33, Issue: 11, Pages: 1168-1178 |
| ISSN: | 1569-8041 |
| DOI: | 10.1016/j.annonc.2022.08.002 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.annonc.2022.08.002 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0923753422038662 
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| Author Notes: | F. Griesinger, G. Curigliano, M. Thomas, V. Subbiah, C.S. Baik, D.S.W. Tan, D.H. Lee, D. Misch, E. Garralda, D.-W. Kim, A.J. van der Wekken, J.F. Gainor, L. Paz-Ares, S.V. Liu, G.P. Kalemkerian, Y. Houvras, D.W. Bowles, A.S. Mansfield, J.J. Lin, V. Smoljanovic, A. Rahman, S. Kong, A. Zalutskaya, M. Louie-Gao, A.L. Boral & J. Mazières |
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| 245 | 1 | 0 | |a Safety and efficacy of pralsetinib in RET fusion-positive non-small-cell lung cancer including as first-line therapy |b update from the ARROW trial |c F. Griesinger, G. Curigliano, M. Thomas, V. Subbiah, C.S. Baik, D.S.W. Tan, D.H. Lee, D. Misch, E. Garralda, D.-W. Kim, A.J. van der Wekken, J.F. Gainor, L. Paz-Ares, S.V. Liu, G.P. Kalemkerian, Y. Houvras, D.W. Bowles, A.S. Mansfield, J.J. Lin, V. Smoljanovic, A. Rahman, S. Kong, A. Zalutskaya, M. Louie-Gao, A.L. Boral & J. Mazières |
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| 520 | |a Background - RET fusions are present in 1%-2% of non-small-cell lung cancer (NSCLC). Pralsetinib, a highly potent, oral, central nervous system-penetrant, selective RET inhibitor, previously demonstrated clinical activity in patients with RET fusion-positive NSCLC in the phase I/II ARROW study, including among treatment-naive patients. We report an updated analysis from the ARROW study. - Patients and methods - ARROW is a multi-cohort, open-label, phase I/II study. Eligible patients were ≥18 years of age with locally advanced or metastatic solid tumours and an Eastern Cooperative Oncology Group performance status of 0-2 (later 0-1). Patients initiated pralsetinib at the recommended phase II dose of 400 mg once daily until disease progression, intolerance, consent withdrawal, or investigator’s decision. The co-primary endpoints (phase II) were overall response rate (ORR) by blinded independent central review and safety. - Results - Between 17 March 2017 and 6 November 2020 (data cut-off), 281 patients with RET fusion-positive NSCLC were enrolled. The ORR was 72% [54/75; 95% confidence interval (CI) 60% to 82%] for treatment-naive patients and 59% (80/136; 95% CI 50% to 67%) for patients with prior platinum-based chemotherapy (enrolment cut-off for efficacy analysis: 22 May 2020); median duration of response was not reached for treatment-naive patients and 22.3 months for prior platinum-based chemotherapy patients. Tumour shrinkage was observed in all treatment-naive patients and in 97% of patients with prior platinum-based chemotherapy; median progression-free survival was 13.0 and 16.5 months, respectively. In patients with measurable intracranial metastases, the intracranial response rate was 70% (7/10; 95% CI 35% to 93%); all had received prior systemic treatment. In treatment-naive patients with RET fusion-positive NSCLC who initiated pralsetinib by the data cut-off (n = 116), the most common grade 3-4 treatment-related adverse events (TRAEs) were neutropenia (18%), hypertension (10%), increased blood creatine phosphokinase (9%), and lymphopenia (9%). Overall, 7% (20/281) discontinued due to TRAEs. - Conclusions - Pralsetinib treatment produced robust efficacy and was generally well tolerated in treatment-naive patients with advanced RET fusion-positive NSCLC. Results from the confirmatory phase III AcceleRET Lung study (NCT04222972) of pralsetinib versus standard of care in the first-line setting are pending. | ||
| 650 | 4 | |a frontline therapy | |
| 650 | 4 | |a non-small-cell lung cancer | |
| 650 | 4 | |a pralsetinib | |
| 650 | 4 | |a RET fusion | |
| 650 | 4 | |a RET inhibition | |
| 650 | 4 | |a targeted therapy | |
| 700 | 1 | |a Curigliano, G. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Thomas, Michael |e VerfasserIn |0 (DE-588)1054438781 |0 (DE-627)79152213X |0 (DE-576)41027089X |4 aut | |
| 700 | 1 | |a Subbiah, V. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Baik, C. S. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Tan, D. S. W. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Lee, D. H. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Misch, D. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Garralda, E. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Kim, D. -W. |e VerfasserIn |4 aut | |
| 700 | 1 | |a van der Wekken, A. J. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Gainor, J. F. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Paz-Ares, L. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Liu, S. V. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Kalemkerian, G. P. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Houvras, Y. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Bowles, D. W. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Mansfield, A. S. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Lin, J. J. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Smoljanovic, V. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Rahman, A. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Kong, S. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Zalutskaya, A. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Louie-Gao, M. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Boral, A. L. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Mazières, J. |e VerfasserIn |4 aut | |
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