RET fusion in advanced NSCLC (~1-2% of adenocarcinoma): selpercatinib (LIBRETTO-001 Drilo...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-RET-FUSION-NSCLC |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Diseases | DIS-NSCLC |
| Sources | SRC-CIVIC SRC-ESMO-NSCLC-METASTATIC-2024 SRC-NCCN-NSCLC-2025 |
Actionability Facts
| Biomarker | BIO-RET |
|---|---|
| Variant | fusion (gene-level — KIF5B-RET, CCDC6-RET, NCOA4-RET et al.) |
| Disease | DIS-NSCLC |
| ESCAT tier | IA |
| Recommended combinations | selpercatinib monotherapy (1L preferred per LIBRETTO-431), pralsetinib monotherapy |
| Contraindicated monotherapy | cabozantinib / vandetanib (inferior to selective RET-TKIs in NSCLC) |
| Evidence summary | RET fusion in advanced NSCLC (~1-2% of adenocarcinoma): selpercatinib (LIBRETTO-001 Drilon 2020 — ORR 64% prior-tx / 85% TKI-naive; LIBRETTO-431 1L vs platinum-pemetrexed) and pralsetinib (ARROW Gainor 2021 — ORR 70%) are highly selective RET-TKIs with deep, durable responses including in CNS. Multikinase TKIs (cabozantinib, vandetanib) are inferior and toxic. |
Notes
ESCAT IA. OncoKB Level 1. Detection: RNA-NGS preferred over DNA-NGS (intronic breakpoints). KIF5B-RET most common partner (~70%); fusion-partner generally does not influence TKI response (unlike ALK). Trial-source gaps: SRC-LIBRETTO001-DRILON-2020, SRC-LIBRETTO-431, SRC-ARROW not yet ingested.
Used By
No reverse references found in the YAML corpus.