Selpercatinib is in clinical development for the treatment of metastatic RET fusion-positive non-small cell lung cancer (NSCLC). NSCLC is the most common type of lung cancer and at the metastatic stage the disease has already spread from the lungs to other sites. Around 2% of these patients will have tumours that contain fusion mutations in the RET gene. Cells in these tumour produce altered RET signalling receptors that allow uncontrolled cancer growth. Currently the only treatment options that attempt to inhibit RET fusion-positive tumour activity are nonselective multikinase inhibitors.
Selpercatinib is a first-in-class oral precision cancer medicine designed to selectively bind to cancers that harbour genetic abnormalities in the RET proteins. This binding inhibits the RET receptor signalling which in turn inhibits the tumour cell growth and may also prevent resistance to the treatment from developing. Selpercatinib is being developed for NSCLC and other advanced solid tumours with RET genetic alterations with early results indicating significantly improved outcomes. If licensed, selpercatinib will offer a first-in-class treatment option for RET-fusion positive NSCLC, who currently have no highly selective therapies available.
Pembrolizumab is an immunomodulatory medicinal product, meaning that it helps the immune system to recognise and attack cancer cells. It is administered by intravenous infusion and is currently licensed in the UK for melanoma, non-small cell lung cancer and urothelial cancer – amongst others. If licensed, pembrolizumab, in addition to chemotherapy, would offer an alternative treatment for those with advanced, recurrent or metastatic cervical cancer.