Precision therapy for RET-altered cancers with RET inhibitors

Trends Cancer. 2021 Dec;7(12):1074-1088. doi: 10.1016/j.trecan.2021.07.003. Epub 2021 Aug 12.

Abstract

Rearranged during transfection (RET) is involved in the physiological development of some organ systems. Activating RET alterations via either gene fusions or point mutations are potent oncogenic drivers in non-small cell lung cancer, thyroid cancer, and in multiple diverse cancers. RET-altered cancers were initially treated with multikinase inhibitors (MKIs). The efficacy of MKIs was modest at the expense of notable toxicities from their off-target activity. Recently, highly potent and RET-specific inhibitors selpercatinib and pralsetinib were successfully translated to the clinic and FDA approved. We summarize the current state-of-the-art therapeutics with preclinical and clinical insights of these novel RET inhibitors, acquired resistance mechanisms, and future outlooks.

Keywords: BLU-667 (pralsetinib); LOXO-292 (selpercatinib); RET-altered cancers; lung cancer; multikinase inhibitors; thyroid cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Humans
  • Lung Neoplasms* / drug therapy
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use
  • Proto-Oncogene Proteins c-ret / genetics
  • Proto-Oncogenes

Substances

  • Protein Kinase Inhibitors
  • Proto-Oncogene Proteins c-ret
  • RET protein, human