Rachelle Hamadi, Hematology Oncology Fellow and Research Leader at SUNY Downstate Medical Center, shared a post on LinkedIn:
”The LIBRETTO-432 data is officially out, and it is a major win for precision medicine in early-stage lung cancer. This Phase 3 trial evaluated adjuvant selpercatinib (Retevmo) versus placebo in patients with resected, early-stage (IB-IIIA) RET fusion-positive NSCLC, and the results are immediately practice-changing.
Key takeaways from the presentation:
- Event-Free Survival (EFS): A massive 83% reduction in the risk of disease recurrence or death (HR 0.17) in the primary analysis population (Stage II-IIIA).
- 24-Month EFS Rate: 92% for selpercatinib vs. 61% for placebo.
- Safety Profile: Consistent with what we see in the advanced setting. The primary grade ≥3 events were elevated ALT/AST, which were manageable with dose modifications.
Historically, we’ve relied heavily on standard-of-care surgery and adjuvant chemo, but patients with these rare RET fusions remain at high risk for recurrence.
This data proves that targeting micrometastatic disease with a specific kinase inhibitor significantly extends event-free survival.
Most importantly, it heavily reinforces the need for comprehensive molecular biomarker testing right at the time of diagnosis, rather than waiting until a patient reaches the metastatic setting! ”
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