Dr. Pecot on Selecting Between Available Targeted Therapies in NSCLC

Chad V. Pecot, MD, associate professor of oncology, Department of Medicine, University of North Carolina Lineberger Comprehensive Cancer Center, discusses selecting between available targeted therapies in RET-, KRAS-, and MET exon 14 (METex14) skipping–mutant non–small cell lung cancer (NSCLC).

Selpercatinib (Retevmo) and pralsetinib (Gavreto) are FDA-approved options to treat patients with RET-mutant NSCLC. Capmatinib (Tabrecta) and tepotinib (Tepmetko) are available for use in patients with NSCLC who harbor METex14 skipping mutations. Although sotorasib (Lumakras) is the only FDA-approved targeted option for patients with KRAS G12C mutations, adagrasib (MRTX849) has received a breakthrough therapy designation from the FDA and could be approved soon.

These options are highly potent and effective for their respective subgroup of NSCLC, Pecot says. Additionally, the agents are more selective against RET, KRAS G12C, and METex14 skipping mutations, respectively, compared with earlier generation inhibitors.

As such, physician comfort tends to drive treatment selection between the available agents, Pecot explains. In the academic setting, many clinicians had the opportunity to utilize specific agents in clinical trials, so their comfort level with that agent vs the other may be greater, Pecot concludes.