Expert Point of View: Laura Locati, MD, PhD
Invited discussant of the LIBRETTO-531 trial, Laura Locati, MD, PhD, Associate Professor of Medical Oncology, Department of Internal Medicine and Therapeutics, University of Pavia and Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Italy, commented: “Selpercatinib is a new standard of care for RET-positive progressive medullary thyroid cancer.”
Laura Locati, MD, PhD
Dr. Locati continued: “Vandetinib and cabozantinib have off-target toxicities, leading to dose reductions and drug discontinuations. Selpercatinib is a potent, selective RET inhibitor associated with fewer side effects. It significantly reduced the risk of disease progression by 72% compared with multikinase inhibitors and was associated with remarkable overall and complete response rates. At the interim analysis, the trend for survival favored selpercatinib, although longer follow-up is needed.”
“These results support mandatory somatic RET testing in all medullary thyroid cancer patients with advanced metastatic disease,” she stated.
Dr. Locati noted that multikinase inhibitors “are an option beyond selpercatinib.”
DISCLOSURE: Dr. Locati has received honoraria from or served on the advisory board to Eisai, MSD, Merck Serono, Eli Lilly, Sanofi, Sun Pharma, Ipsen, Bayer, Roche, Istituto Gentili Srl, New Bridges, and Seagen; and received reimbursement for travel from Gilead Sciences.
First-line treatment with selpercatinib achieved a statistically significant improvement in progression-free survival and overall response rate vs treatment with cabozantinib or vandetanib in patients with multikinase inhibitor–naive, RET-mutant advanced or metastatic medullary thyroid cancer.1