NSCLC Case Study 2: Navigating Treatment After a RET Fusion Discovery

Experts discuss how the final pathology report, which included an RNA-based NGS test, definitively resolved the case by identifying a RET fusion. They highlight this finding as a critical justification for comprehensive biomarker testing, especially in never-smoker patients where initial results are negative.

This discovery significantly alters the treatment paradigm. The panel agrees that while adjuvant chemotherapy remains a standard consideration, the presence of the RET fusion makes the patient an ideal candidate for a clinical trial investigating RET inhibitors in the adjuvant setting. They base this on robust data from the metastatic setting (e.g., the LIBRETTO trial) showing that targeted therapy vastly outperforms chemotherapy and immunotherapy for these specific drivers. The experts conclude that the low PD-L1 level and the patient's never-smoker status further diminish the potential benefit of immunotherapy, solidifying the priority of seeking a trial for a RET inhibitor.