Selpercatinib – a new option for a precision approach to the treatment of medullary thyroid cancer

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Abstract

Introduction. Multikinase inhibitors are used to treat nonresectable locally advanced and/or metastatic medullary thyroid cancer (MTC). However  they are characterized by high toxicity associated with kinase inhibition. Selective RET inhibitor selpercatinib demonstrates high selectivity and tolerance which makes it a promising agent for MTC treatment.

Aim. To evaluate selpercatinib effectiveness and tolerance in patients with metastatic MTC associated with a mutation in the RET gene.

Materials and methods. The study included 9 patients with metastatic MTC and mutation in the RET gene who received treatment with selpercatinib 160 mg 2 times a day. The drug effectiveness was evaluated every 2–3 months based on the results of multispiral computed tomography of the whole body and tumor marker (calcitonin and carcinoembryonic antigen) levels.

Results. Median duration of therapy was 29 months  overall response rate was 78 %; complete response was observed in 56 % of patients. After 12 months of therapy  progression-free survival was 100 %; after 24 months  it was 89 %. Persistent decrease in calcitonin level (by more than 90 %) was achieved in all patients. The most common adverse events were arterial hypertension and insignificant creatinine increase.

Conclusion. The results of therapy show significant improvement in the rate of objective response and progression[1]free survival which makes selpercatinib a preferential treatment choice in this category of patients.

About the authors

A. K. Plugar

A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Centre, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0002-0049-4309

4 Koroleva St., Obninsk 249036

Russian Federation

N. V. Severskaya

A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Centre, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0002-9426-8459

4 Koroleva St., Obninsk 249036

Russian Federation

P. A. Isaev

A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Centre, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0009-0001-2728-2154

4 Koroleva St., Obninsk 249036

Russian Federation

Yu. A. Panaseykin

A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Centre, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0003-4537-0534

4 Koroleva St., Obninsk 249036

Russian Federation

V. V. Polkin

A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Centre, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0003-0857-321X

4 Koroleva St., Obninsk 249036

Russian Federation

L. N. Vatina

A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Centre, Ministry of Health of Russia

Author for correspondence.
Email: vatina1995@gmail.com
ORCID iD: 0009-0005-5043-7301

Liana Nodarievna Vatina

4 Koroleva St., Obninsk 249036

Russian Federation

T. A. Agababyan

A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Centre, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0002-9971-3451

4 Koroleva St., Obninsk 249036

Russian Federation

S. А. Ivanov

A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Centre, Ministry of Health of Russia; Peoples’ Friendship University of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0001-7689-6032

4 Koroleva St., Obninsk 249036

6 Miklukho-Maklaya St., Moscow 117198

Russian Federation

A. D. Kaprin

National Medical Research Radiological Centre, Ministry of Health of Russia; P.A. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0001-8784-8415

3 2nd Botkinsky Proezd, Moscow125284

Russian Federation

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