Selpercatinib Controls Central Nervous System Disease in Patients With NSCLC With RET Fusion

A recent study involved 61 patients with RET fusion-positive advanced NSCLC with and without central nervous system (CNS) metastases treated with selpercatinib. 1 Murciano-Goroff Y.R. Falcon C.J. Lin S.T. et al. Central nervous system disease in patients with RET fusion-positive NSCLC treated with selpercatinib. J Thorac Oncol. 2023; 18: 620-627 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar The CNS progression was not observed in patients without baseline CNS disease, and CNS progression was rare in patients with baseline CNS disease. 1 Murciano-Goroff Y.R. Falcon C.J. Lin S.T. et al. Central nervous system disease in patients with RET fusion-positive NSCLC treated with selpercatinib. J Thorac Oncol. 2023; 18: 620-627 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar In clinical aspects, early initiation of selpercatinib is associated with decreased rates of CNS metastasis formation and progression; therefore, selpercatinib may play a preventive role. 1 Murciano-Goroff Y.R. Falcon C.J. Lin S.T. et al. Central nervous system disease in patients with RET fusion-positive NSCLC treated with selpercatinib. J Thorac Oncol. 2023; 18: 620-627 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar Current study accumulates legitimate evidence for advanced NSCLC CNS metastasis prevention, although there are some considerations before clinical practice. Oligo-recurrence and Sync-oligometastasesJournal of Thoracic OncologyVol. 13Issue 4PreviewWe thank Widder and Lodeweges for their reply to our letter to the editor.1 They defined oligo-recurrence as lymph node metastases and did not include parenchymal metastases.1 However, we defined the concept of oligo-recurrence as one to five metastases or recurrences (not including local recurrence) and controlled primary lesions.2,3 Thus, our concept of oligo-recurrence included parenchymal metastases or recurrences. We have also previously reported lung and brain oligo-recurrence.4,5 Therefore, the description of oligo-recurrence in the article by Widder and Lodeweges is not appropriate. Full-Text PDF Open ArchiveIn Reply to "Selpercatinib Controls Central Nervous System Disease in Patients With RET Fusion-Positive NSCLC"Journal of Thoracic OncologyVol. 18Issue 5PreviewWe are grateful for the comments of Zhao et al. regarding our recently published article.1 Selpercatinib has received approval for the first-line treatment of advanced, RET fusion-positive NSCLC on the basis of a well-defined safety and efficacy profile.2,3 Our article evaluated the patterns of metastatic spread among patients treated with selpercatinib, with emphasis on central nervous system (CNS) disease. Full-Text PDF