Successful Treatment of Metastatic Lung Cancer with Fusion KIF RET Amplification Using Alectinib in the Absence of Selpercatinib and Pralsetinib: A Case Report and Literature Review

Mataji, Maedeh; Ramezaninejad, Soodeh

doi:10.22034/atj.2024.198818

Successful Treatment of Metastatic Lung Cancer with Fusion KIF RET Amplification Using Alectinib in the Absence of Selpercatinib and Pralsetinib: A Case Report and Literature Review

Reviewers

Authors

Maedeh Mataji

Soodeh Ramezaninejad

Hematology and Oncology fellowship, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

10.22034/atj.2024.198818

Abstract

Background: The treatment landscape for advanced non-small cell lung cancer (NSCLC) has evolved significantly with the emergence of targeted therapies. Among these, tyrosine kinase inhibitors (TKIs) selective for the rearranged during transfection (RET) gene have shown promise. However, understanding resistance mechanisms and identifying effective treatments for patients progressing on RET-TKIs remains a challenge.
Case description: we present a patient with metastatic lung cancer harboring a fusion involving KIF5B-RET amplification. Notably, this patient did not receive Selpercatinib or Pralsetinib, two RET-selective TKIs commonly used in RET-positive NSCLC. Instead, the patient was successfully treated with Alectinib, highlighting the potential efficacy of this alternative therapy.
Conclusion: Our case report, provides a comprehensive overview of RET-positive advanced NSCLC, covering both therapeutic and molecular aspects. We compare clinical outcomes achieved with multikinase inhibitors (MKIs) and RET-selective TKIs, emphasizing the long-term resistance mechanisms. Additionally, we discuss unresolved issues and propose future pharmacological approaches.

Keywords

NSCLC

RET fusion

TKI

drug resistance