Use of Pralsetinib as Neoadjuvant Therapy for Non-Small Cell Lung Cancer Patient With RET Rearrangement

Ning Zhou; Tong Li; Maoli Liang; Fan Ren; Hong Ni; Wei Liu; Tao Shi; Dongbo Xu; Qiusong Chen; Haonan Yu; Zuoqing Song; Lingling Zu; Shuo Li; Song Xu

doi:10.3389/fonc.2022.848779

Use of Pralsetinib as Neoadjuvant Therapy for Non-Small Cell Lung Cancer Patient With RET Rearrangement

Front Oncol. 2022 Feb 10:12:848779. doi: 10.3389/fonc.2022.848779. eCollection 2022.

Authors

Ning Zhou^{1

2}, Tong Li^{1

2}, Maoli Liang³, Fan Ren^{1

2}, Hong Ni^{1

2}, Wei Liu⁴, Tao Shi⁵, Dongbo Xu⁶, Qiusong Chen⁷, Haonan Yu⁷, Zuoqing Song^{1

2}, Lingling Zu^{1

2}, Shuo Li³, Song Xu^{1

2}

Affiliations

¹ Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, China.
² Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China.
³ Department of Respiratory and Critical Care, Tianjin Medical University General Hospital, Tianjin, China.
⁴ Department of Respiratory Medicine, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
⁵ Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China.
⁶ Department of Pathology, Tianjin Medical University General Hospital, Tianjin, China.
⁷ Department of PET/CT Diagnostic, Tianjin Medical University General Hospital, Tianjin, China.

Abstract

RET rearrangements are rare, and occur in 1%-2% of all non-small cell lung cancer (NSCLC) patients. Pralsetinib has a significant anti-tumor effect in patients with advanced NSCLC and a RET rearrangement. Previous studies have confirmed the efficiency of neoadjuvant target therapy for NSCLC. Herein we present a case involving a female patient who was diagnosed with stage IIIA lung adenocarcinoma and harbored a KIF5B-RET rearrangement based on next-generation sequencing. Radiologic downstaging was indicated after pralsetinib treatment. Therefore, a right lower lobectomy and systemic lymphadenectomy were successfully performed. The postoperative pathologic results revealed a response rate of 74% for primary tumor and no residual viable tumor cells were observed in lymph nodes. The tumor, nodes, and metastases (TNM) stage was ypT1cN1M0. The tumor micro-environment (TME) of the primary tumor was also assessed.

Keywords: RET; locally advanced (stage III) non-small cell lung cancer; neoadjuvant; pralsetinib; targeted therapy.