Deborah B. Doroshow, MD, PhD, assistant professor, medicine, the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, discusses the similarities and differences between the efficacy and safety profiles of pralsetinib (Gavreto) and selpercatinib (Retevmo) in patients with non–small cell lung cancer (NSCLC) harboring 

 fusion–positive NSCLC, based on findings from the phase 1/2 ARROW trial (NCT03037385), in which the agent led to an overall response rate (ORR) of 57% (95% CI, 46%-68%). In 2022, 

the FDA granted regular approval to selpercatinib

 for patients with locally advanced or metastatic, 

 fusion–positive NSCLC, based on confirmatory follow-up data from the lung cancer arm of the phase 1/2 LIBRETTO-001 trial (NCT03157128), in which the ORR was 61% (95% CI, 55%-67%) with the agent.

Pralsetinib and selpercatinib have similar efficacy profiles in patients with NSCLC, as both agents penetrate the central nervous system and elicit high rates of durable responses, Doroshow says. Additionally, both drugs are effective in the frontline setting and after progression on platinum-based chemotherapy, Doroshow notes.

However, although selpercatinib and pralsetinib are both associated with adverse effects such as fatigue, the 2 agents can cause differential toxicities as well, Doroshow explains. For instance, pralsetinib is associated with higher levels of decreased white blood cell counts than selpercatinib. In ARROW, 34% of patients experienced any-grade leukopenia. Leukopenia was not reported in patients with lung cancer in LIBRETTO-001. Additionally, selpercatinib is associated with higher levels of liver function elevation than pralsetinib. In LIBRETTO-001, 36.7% and 35.7% of patients in the lung cancer cohort experienced increased aspartate aminotransferase and increased alanine aminotransferase, respectively, vs 41% and 30% of patients, respectively, in ARROW.

Although selpercatinib and pralsetinib generate similar efficacy outcomes in patients with 

 fusion–positive NSCLC, their safety profiles are not identical or interchangeable, Doroshow emphasizes.

Videos

Deborah B. Doroshow, MD, PhD, discusses the similarities and differences between the efficacy and safety profiles of pralsetinib and selpercatinib in patients with non–small cell lung cancer harboring RET fusions.

Dr Doroshow on RET Inhibitors in RET Fusion+ NSCLC

Deborah B. Doroshow, MD, PhD, assistant professor of medicine, hematology, and medical oncology, Mount Sinai ​Hospital, discusses the impact of the coronavirus disease 2019 (COVID-19) pandemic on cancer care.

The COVID-19 pandemic continues to alter cancer care across the globe, says Doroshow.

For a period of time, New York City was the center of the pandemic with regard to a spike in the number of COVID-19 diagnoses, Doroshow explains

Recent​ly, research ​has suggest​ed that patients with cancer, as well as those with a history of cancer, are at ​an increased risk of both contracting COVID-19 and ​having a poor outcome ​due to the virus, ​says Doroshow.

The aim of the multicenter COVID-19 and Cancer Outcomes Study, ​which was presented during the virtual 2020 ESMO Congress, was to evaluate the ​ways in which the changes that were made to cancer care have impact​ed the overall outcomes ​of patients with cancer, Doroshow concludes.

Deborah B. Doroshow, MD, PhD, discusses the impact of the coronavirus disease 2019 pandemic on cancer care.

Deborah B. Doroshow, MD, PhD

Articles

Dr Doroshow on RET Inhibitors in RET Fusion+ NSCLC

Dr. Doroshow on the Impact of the COVID-19 Pandemic on Cancer Care