Comparing the effectiveness of Selpercatinib to the standard therapy of Vandetanib or Cabozantinib in treating medullary thyroid cancer
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on January 8th, 2024
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Medullary thyroid cancer is associated with the uncontrollable cell growth associated with mutation to the RET gene. The condition is currently being treated with either Vandetanib or Cabozantinib. These two agents can bind to and inactivate the RET kinase; however, they caused a lot of side effects and resistance against the agents had been reported. As a result, studies had been conducted to find a better treatment. A paper published in the New England Journal of Medicine had assessed the effectiveness of Selpercatinib, a highly-selective RET kinase inhibitor, in treating medullary thyroid cancer.
The phase 3 clinical trial included 291 patients who had been diagnosed with unresectable advanced or metastatic medullary thyroid cancer. Using imaging and the RECIST criteria, the researchers had found that the thyroid cancer had progressed in these patients within the past 14 months. Sequencing was also performed to evaluate the integrity of the gene encoded for the RET kinase. The study intentionally enrolled patients whose disease was mild to moderate as adjudicated by a score from 0 to 2 on the Eastern Cooperative Oncology Group. The patients were randomly assigned to be treated with either Selpercatinib or the current standard regimen. Selpercatinib was administered orally twice a day at a dose of 160 mg. For patients in the standard care group, they were treated with either Cabozantinib (140 mg once daily) or Vandetanib (300 mg once daily) based on the decision of the primary care physician. After 12 months, the researchers observed that Selpercatinib helped reduce the risk of death or disease progression by 72%. In the Selpercatinib group, 86.8% of the patients did not experience any disease progression or death by the 12th month; which is higher than the 65.7% observed in the standard therapy group. In addition to the higher effectiveness, Selpercatinib was proven to be better tolerated. Only 4.7% of the patients treated with Selpercatinib had to discontinue treatment due to adverse effects, which was significantly lower than the 26.8% in the standard therapy group.
The phase 3 clinical trial included 291 patients who had been diagnosed with unresectable advanced or metastatic medullary thyroid cancer. Using imaging and the RECIST criteria, the researchers had found that the thyroid cancer had progressed in these patients within the past 14 months. Sequencing was also performed to evaluate the integrity of the gene encoded for the RET kinase. The study intentionally enrolled patients whose disease was mild to moderate as adjudicated by a score from 0 to 2 on the Eastern Cooperative Oncology Group. The patients were randomly assigned to be treated with either Selpercatinib or the current standard regimen. Selpercatinib was administered orally twice a day at a dose of 160 mg. For patients in the standard care group, they were treated with either Cabozantinib (140 mg once daily) or Vandetanib (300 mg once daily) based on the decision of the primary care physician. After 12 months, the researchers observed that Selpercatinib helped reduce the risk of death or disease progression by 72%. In the Selpercatinib group, 86.8% of the patients did not experience any disease progression or death by the 12th month; which is higher than the 65.7% observed in the standard therapy group. In addition to the higher effectiveness, Selpercatinib was proven to be better tolerated. Only 4.7% of the patients treated with Selpercatinib had to discontinue treatment due to adverse effects, which was significantly lower than the 26.8% in the standard therapy group.