Thoracic Cancer (Nov 2023)

Expert consensus on the diagnosis and treatment of RET gene fusion non‐small cell lung cancer in China

  • Xingxiang Pu,
  • Chunwei Xu,
  • Qian Wang,
  • Wenxian Wang,
  • Fang Wu,
  • Xiuyu Cai,
  • Zhengbo Song,
  • Jinpu Yu,
  • Wenzhao Zhong,
  • Zhijie Wang,
  • Yongchang Zhang,
  • Jingjing Liu,
  • Shirong Zhang,
  • Anwen Liu,
  • Wen Li,
  • Ping Zhan,
  • Hongbing Liu,
  • Tangfeng Lv,
  • Liyun Miao,
  • Lingfeng Min,
  • Gen Lin,
  • Long Huang,
  • Jingping Yuan,
  • Zhansheng Jiang,
  • Chuangzhou Rao,
  • Dongqing Lv,
  • Zongyang Yu,
  • Xiaoyan Li,
  • Chuanhao Tang,
  • Chengzhi Zhou,
  • Junping Zhang,
  • Hui Guo,
  • Qian Chu,
  • Rui Meng,
  • Xuewen Liu,
  • Jingxun Wu,
  • Jin Zhou,
  • Zhengfei Zhu,
  • Weiwei Pan,
  • Fei Pang,
  • Jintao Huang,
  • Kai Wang,
  • Fan Wu,
  • Tingting Shen,
  • Shirui Zou,
  • Bingwei Xu,
  • Liping Wang,
  • Youcai Zhu,
  • Xinqing Lin,
  • Jing Cai,
  • Ling Xu,
  • Jisheng Li,
  • Xiaodong Jiao,
  • Kainan Li,
  • Huijing Feng,
  • Lin Wang,
  • Yingying Du,
  • Wang Yao,
  • Xuefei Shi,
  • Xiaomin Niu,
  • Dongmei Yuan,
  • Yanwen Yao,
  • Jing Kang,
  • Jiatao Zhang,
  • Chao Zhang,
  • Jianfei Fu,
  • Jianhui Huang,
  • Yinbin Zhang,
  • Pingli Sun,
  • Hong Wang,
  • Mingxiang Ye,
  • Dong Wang,
  • Zhaofeng Wang,
  • Yue Hao,
  • Zhen Wang,
  • Bing Wan,
  • Donglai Lv,
  • Gang Lan,
  • Shengjie Yang,
  • Lin Shi,
  • Yina Wang,
  • Bihui Li,
  • Zhang Zhang,
  • Zhongwu Li,
  • Yuan Li,
  • Zhefeng Liu,
  • Nong Yang,
  • Huijuan Wang,
  • Wenbin Huang,
  • Zhuan Hong,
  • Guansong Wang,
  • Jiandong Wang,
  • Meiyu Fang,
  • Yong Fang,
  • Xixu Zhu,
  • Yi Shen,
  • Yiping Zhang,
  • Shenglin Ma,
  • Yong Song,
  • Yuanzhi Lu,
  • Wenfeng Fang,
  • Ziming Li,
  • Lin Wu

DOI
https://doi.org/10.1111/1759-7714.15105
Journal volume & issue
Vol. 14, no. 31
pp. 3166 – 3177

Abstract

Read online

Abstract The rearranged during transfection (RET) gene is one of the receptor tyrosine kinases and cell‐surface molecules responsible for transmitting signals that regulate cell growth and differentiation. In non‐small cell lung cancer (NSCLC), RET fusion is a rare driver gene alteration associated with a poor prognosis. Fortunately, two selective RET inhibitors (sRETi), namely pralsetinib and selpercatinib, have been approved for treating RET fusion NSCLC due to their remarkable efficacy and safety profiles. These inhibitors have shown the ability to overcome resistance to multikinase inhibitors (MKIs). Furthermore, ongoing clinical trials are investigating several second‐generation sRETis that are specifically designed to target solvent front mutations, which pose a challenge for first‐generation sRETis. The effective screening of patients is the first crucial step in the clinical application of RET‐targeted therapy. Currently, four methods are widely used for detecting gene rearrangements: next‐generation sequencing (NGS), reverse transcription‐polymerase chain reaction (RT‐PCR), fluorescence in situ hybridization (FISH), and immunohistochemistry (IHC). Each of these methods has its advantages and limitations. To streamline the clinical workflow and improve diagnostic and treatment strategies for RET fusion NSCLC, our expert group has reached a consensus. Our objective is to maximize the clinical benefit for patients and promote standardized approaches to RET fusion screening and therapy.

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