LIBRETTO-531: selpercatinib versus cabozantinib or vandetanib in advanced RET-mutant medullary thyroid cancer
The selective RET inhibitor selpercatinib cut the risk of progression by more than 70 percent compared with the older multikinase drugs cabozantinib and vandetanib in RET-mutant medullary thyroid cancer, with fewer side effects.
Overview
Phase 3 trial of 291 patients with progressive advanced RET-mutant medullary thyroid cancer randomised 2:1 to selpercatinib or physician's choice of cabozantinib or vandetanib.
Progression-free survival at 12 months was 86.8 versus 65.7 percent (hazard ratio 0.28), response 69.4 versus 38.8 percent, and treatment-failure-free survival also favoured selpercatinib; grade 3 or higher adverse events were 52.8 versus 76.3 percent.
- Twelve-month progression-free survival 86.8 percent vs 65.7 percent; hazard ratio 0.28.
- Objective response 69.4 percent vs 38.8 percent.
Selpercatinib is the first-line standard for advanced RET-mutant medullary thyroid cancer; RET testing at diagnosis is essential.
- Overall survival data immature.
- Open-label design.
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