Retevmo (selpercatinib) is a medicine that is used in adults for certain types of non-small-cell lung cancer (NSCLC) that have a certain fusion in a gene known as receptor tyrosine kinase (RET). This is known as RET-positive NSCLC. Retevmo may also be used to treat other types of cancer.
How Does Retevmo Work for Lung Cancer?
RET is a gene that sends signals to cells in your body to tell them to grow. When a RET gene fusion happens on a cell, it tells the cells to multiply, which can make the cells grow quickly and can cause a cancer cell that creates a tumor and grows and spreads. Retevmo is a type of medicine called a kinase inhibitor, and it blocks the action of RET gene fusions. By blocking RET fusions, Retevmo can help stop cancer cells from growing and spreading.
What Kinds of Lung Cancer Does Retevmo Treat?
Lung cancer that is RET-positive may be able to be treated by Retevmo. It may be used in people when their RET-positive lung cancer has spread locally or metastatically (spread to other areas) in their body. Tumor tissue that is surgically removed will be tested for RET gene fusions.
How Do I Use Retevmo for Lung Cancer?
Retevmo is a capsule that you will swallow. You will take your Retevmo dose once a day with or without food. You should try to take it around the same time every day. Retevmo capsules should be taken whole, and you should not crush or chew them. Your actual dose of Retevmo will depend on your weight, and your health care provider will help find the right dose for you. You will continue taking Retevmo for as long as possible, meaning you will take it until your cancer progresses or you have side effects that make it not safe for you to take. If you have certain side effects, you may have to have a change in your dose, pause your doses, or stop them altogether. Your health care provider will talk with you about how long you can expect to take Retevmo.
If you are taking certain medications to reduce acid in your stomach, you may need to take Retevmo with food or within a certain amount of time before or after the other medicine. Examples of these medicines include proton pump inhibitors (PPIs), histamine-2 (H2) receptor antagonists, and antacids. Tell your health care provider about all medications and supplements you are taking or plan to take while on Retevmo. They will help to tell you how to take Retevmo so it can be safe and effective for treating your cancer.
How Well Does Retevmo Work for Lung Cancer?
The FDA approved Retevmo based on clinical trials in patients with advanced or metastatic RET-positive lung cancer that progressed on platinum-based chemotherapy, or locally advanced or metastatic disease without previous systemic treatment.
Retevmo was studied in 247 people who had RET-positive lung cancer and had previously received platinum-based chemotherapy in a clinical trial called LIBRETTO-001. There were no other medicines used in this group of people. People enrolled in the trial were evaluated to determine the response they had to Retevmo, which was measured by how much their tumor shrank while receiving the medicine. This was called the overall response rate (ORR). The ORR was 64%, meaning that 64% of the patients had a partial or complete response to the medicine. The clinical trial also looked at progression-free survival (PFS), which measured how long it took for the cancer to progress (grow or spread). The median PFS was 16.5 months, which means at least 50% of the people who had a response to Retevmo were still responding at 16.5 months. These numbers can vary, depending on how the clinical trial information is read, and these show how an external health care provider interpreted the results of people who were in the clinical trial. Talk with your health care provider if you have questions about how well Retevmo might work for you.
Retevmo was also studied in 261 people who had RET-positive lung cancer that had not been previously treated in a clinical trial called LIBRETTO-431. People were enrolled in the trial to either receive treatment with Retevmo or with platinum-based chemotherapy with or without a medicine called pembrolizumab. The group of people who did not receive Retevmo were called the control group. This trial also looked at the ORR and PFS. The ORR in the people who received Retevmo was 84%, compared to 65% for the control group. This means that more people who received Retevmo had a complete or partial response, compared to the control group. The median PFS was 24.8 months in the people who received Retevmo, compared to 11.2 months for the control group. This means that at least 50% of the people who had a response to Retevmo were still responding at 24.8 months.
How Will My Progress Be Monitored?
Retevmo will start working as soon as you take your first dose. Scans will be used to see how your cancer is responding to treatment. Your health care provider will usually do a scan 6 weeks after you start taking the medicine. They may choose to do the scan earlier or later than 6 weeks if they believe it is the right choice for you.
Your health care provider will usually do regular bloodwork or other tests to monitor how Retevmo is working in your body. These tests will monitor your blood counts, such as white blood cells, neutrophils, and platelets, so that your health care provider knows you can safely continue to take Retevmo. If you have certain side effects, such as a cough or shortness of breath, your health care provider may do more tests to make sure it is safe for you to continue to take Retevmo.
How Can I Prevent and Manage Side Effects?
Side effects are common with medicines that treat cancer, including Retevmo. It is important to tell your health care provider about any side effects you have during or after taking Retevmo. They can help to determine if your side effects are serious or provide more information to help you manage side effects.
Your health care provider may instruct you to take certain medicines if you have certain side effects while you take Retevmo. For example, if you have diarrhea while taking Retevmo, your health care provider may suggest that you drink electrolyte replacement liquids, increase the amount of fluids you drink, and take an anti-diarrheal medication.
If you have certain side effects while you take Retevmo, your health care provider may need to change your dose of medicine, pause your doses, or even stop your medicine altogether. This will depend on the side effect you have, how severe it is, and what treatment it needs. If your Retevmo dose needs to be lowered, the medicine will continue to work in your body. If your medicine is paused, it is possible that your health care provider will restart the medication at the same dose or at a lower dose once your side effect is treated and gets better.
What Are Other Unique Considerations to Be Aware Of?
Retevmo can cause harm to an unborn fetus. Your health care provider will discuss options for contraception while you take Retevmo. If you can become pregnant, it is important that you use effective contraception for 1 week after your final dose of Retevmo. If you are assigned male at birth and have a partner who can get pregnant, it is important to use effective contraception for 1 week after your final dose of Retevmo. If you and your partner are or are planning to become pregnant, talk with your health care provider about your options.
It is also possible for Retevmo to cause serious side effects. These include liver problems, lung problems, heart problems, bleeding problems, and others. These side effects can even be life-threatening. It’s important to tell your health care provider if you have any side effects, but especially if you have side effects related to these issues, such as a yellowing of your skin or eyes, coughing, shortness of breath, changes in your heartbeat, headaches, dizziness, blood in your urine, confusion, or chest pain.
If you are taking certain medications, the way you take Retevmo or the dose of Retevmo you take may need to be changed. Examples of these medications include proton pump inhibitors (PPIs) such as omeprazole, histamine-2 (H2) blockers such as famotidine, and antacids. Depending on the specific medication you are taking, you may need to take Retevmo at a certain time before or after the other medication. This is because they can block Retevmo from working properly in your body. Tell your health care provider about all medications and supplements you are taking before starting to take Retevmo.
Is There Any Cost Assistance Available?
The maker of Retevmo has a savings program for financial assistance for some people that may be able to offer coupons for Retevmo doses.
