Salvage Therapy With Selpercatinib for RET-Rearranged NSCLC With Pralsetinib-Related Pneumonitis and Leptomeningeal Disease: A Case Report

Paolo D d'Arienzo; Niamh Cunningham; Hazel O'Sullivan; Charlotte Grieco; Virjen Patel; Sanjay Popat

doi:10.1016/j.jtocrr.2023.100581

Salvage Therapy With Selpercatinib for RET-Rearranged NSCLC With Pralsetinib-Related Pneumonitis and Leptomeningeal Disease: A Case Report

JTO Clin Res Rep. 2023 Sep 29;4(12):100581. doi: 10.1016/j.jtocrr.2023.100581. eCollection 2023 Dec.

Authors

Paolo D d'Arienzo¹, Niamh Cunningham¹, Hazel O'Sullivan¹, Charlotte Grieco¹, Virjen Patel², Sanjay Popat^{1

3}

Affiliations

¹ Lung Unit, Royal Marsden Hospital, London, United Kingdom.
² Clinical Radiology Department, Royal Marsden Hospital, London, United Kingdom.
³ Division of Clinical Studies, Institute of Cancer Research, London, United Kingdom.

Abstract

Selpercatinib and pralsetinib are RET inhibitors with substantial activity in advanced RET-rearranged NSCLC. We present a case of pralsetinib-related pneumonitis and leptomeningeal and brain metastases progression during treatment suspension for pneumonitis. During recovery, selpercatinib administration led to rapid neurologic response and complete intracranial response and allowed pneumonitis resolution. This case supports the safety of selpercatinib in patients with pneumonitis on pralsetinib and highlights its marked efficacy in leptomeningeal disease.

Keywords: Case Report; Leptomeningeal disease; NSCLC; Pralsetinib; RET fusion; Selpercatinib.

Publication types

Case Reports