Lungekreft behandlet med reseptortyrosin=kinasehemmer i utlandet

Abstract

BACKGROUND\nActivating RET fusions are oncogenic drivers in multiple cancers and are identified in 1-2\xa0% of non-small cell lung cancers (NSCLC). Selpercatinib and pralsetinib are tyrosine kinase inhibitors selectively targeting RET and with clinical activity in RET-positive NSCLC.\n\n\nCASE PRESENTATION\nA male never-smoker in his forties was diagnosed with advanced lung adenocarcinoma. With negative tests for EGFR mutations, ROS1\xa0and ALK rearrangements, he was treated with a combination of chemotherapy and an immune checkpoint inhibitor. Upon progression a rebiopsy analysed by next generation sequencing (NGS) revealed a KIF5B-RET fusion. He received treatment with pralsetinib through a compassionate use programme, with relief of symptoms within weeks, and radiological partial response after two months of treatment. He has not experienced side effects after six months of treatment.\n\n\nINTERPRETATION\nPrecision medicine is dependent on diagnostic methods such as NGS to identify patients who might benefit from targeted therapies. Selective inhibitors of molecular oncogenic drivers are usually effective and well tolerated.