Jason Niu, MD, PhD, director of the Lung Cancer Program, Banner MD Anderson Cancer Center, discusses treatment updates in 

-mutant non–small cell lung cancer (NSCLC).

 fusion–positive NSCLC, 2 promising options exist in the space, including pralsetinib (Gavreto) and selpercatinib (Retevmo), according to Niu. It is important that experts within the field familiarize themselves with at least 1 of these agents and feel comfortable with its use, as they are both great first-line options, Niu explains. The earlier these agents are used, the more patients will experience benefit, he continues.

Secondly, the field should be on the lookout for the FDA approvals of sotorasib (Lumakras) and adagrasib (MRTX 849). For those who are not enrolling their patients on clinical trials, within the near future, new agents should be approved for this challenging to treat patient population, Niu concludes.

Videos

Jason Niu, MD, PhD, discusses treatment updates in RET fusion–positive and KRAS-mutant non–small cell lung cancer.

Dr. Niu on Treatment Updates in RET+/KRAS+ NSCLC

Jason Niu, MD, PhD, director, Lung Cancer Program, Banner MD Anderson Cancer Center, discusses considerations for selecting between selpercatinib (Retevmo) and pralsetinib (Gavreto) in 

 fusion–positive non–small cell lung cancer (NSCLC). 

Selpercatinib and pralsetinib are FDA approved for the treatment of patients with metastatic 

 fusion–positive NSCLC, says Niu. Both agents have demonstrated comparable efficacy in this patient population, so selecting between the compounds can present clinical challenges, Niu explains. 

Regarding safety, selpercatinib can cause QT prolongation, which needs to be managed, says Niu. Other agents commonly utilized in lung cancer, such as osimertinib (Tagrisso), can also cause QT prolongation, Niu explains. Patients receiving selpercatinib should have regular EKG tests to identify any changes from baseline, Niu says.

Although, both agents can cause liver dysfunction, they are generally well tolerated, concludes Niu.

Jason Niu, MD, PhD, discusses considerations for selecting between selpercatinib and pralsetinib in RET fusion–positive non–small cell lung cancer.  



Dr. Niu on Selecting Between Selpercatinib and Pralsetinib in RET Fusion+ NSCLC 

Jason Niu, MD, PhD, director, Lung Cancer Program, Banner MD Anderson Cancer Center, discusses combining immunotherapy with VEGF Inhibitors in extensive-stage small cell lung cancer (ES-SCLC).

Combining immunotherapy with VEGF inhibitors has shown efficacy in other tumor types, says Niu.

For example, the combinations of pembrolizumab (Keytruda)/axitinib (Inlyta) and avelumab (Bavencio)/axitinib have been approved for the first-line treatment of patients with advanced renal cell carcinoma. Additionally, bevacizumab (Avastin) plus atezolizumab (Tecentriq) elicited a survival benefit for patients with advanced hepatocellular carcinoma.

It is likely that all patients with ES-SCLC will receive immunotherapy up front based on the positive findings from the phase 3 IMpower133 and CASPIAN studies, says Niu.

However, additional research is needed to determine which immunotherapeutic agent should be given to patients who progress in the first-line setting. There could be clinical rationale to implement immunotherapy/VEGF inhibitor combinations in this setting, concludes Niu.

Jiaxin (Jason) Niu, MD, PhD, discusses combining immunotherapy with VEGF Inhibitors in extensive-stage small cell lung cancer.



Jiaxin (Jason) Niu, MD, PhD

Articles

Dr. Niu on Treatment Updates in RET+/KRAS+ NSCLC

Dr. Niu on Selecting Between Selpercatinib and Pralsetinib in RET Fusion+ NSCLC

Dr. Niu on Combining Immunotherapy With VEGF Inhibitors in ES-SCLC