Amplification of wild-type RET represents a novel molecular subtype of several cancer types with clinical response to selpercatinib Journal Article


Authors: Gandhi, M. M.; Ricciuti, B.; Harada, G.; Repetto, M.; Gildenberg, M. S.; Singh, A.; Li, Y. Y.; Gagné, A.; Wang, X.; Aizer, A.; Fitzgerald, K.; Nishino, M.; Alessi, J.; Pecci, F.; Di Federico, A.; Fisch, A.; Drilon, A.; Nardi, V.; Sholl, L.; Awad, M. M.; Rotow, J.
Article Title: Amplification of wild-type RET represents a novel molecular subtype of several cancer types with clinical response to selpercatinib
Abstract: PURPOSERET rearrangements and RET activating point mutations represent targetable genomic alterations in advanced solid tumors. However, the frequency and clinicopathologic characteristics of wild-type RET amplification in cancer and its potential role as a targetable oncogenic driver are not well-characterized. METHODSIn two institutional cohorts of patients with solid cancers from the Dana-Farber Cancer Institute (DFCI) and Memorial Sloan Kettering Cancer Center (MSKCC) whose tumors underwent next-generation sequencing (NGS), the frequency and clinicopathologic features of wild-type RET amplification in the absence of RET rearrangements or activating mutations was assessed. The findings were validated using merged data from The Cancer Genome Atlas (TCGA), Genomics Evidence Neoplasia Information Exchange (GENIE), and China Pan-Cancer data sets. RESULTSThe frequency of wild-type RET amplification across all solid cancers was 0.08% (26 of 32,505) in the DFCI cohort, 0.05% (26 of 53,152) in the MSKCC cohort, and 0.25% (71 of 28,623) in the cohort from TCGA, GENIE, and China Pan-Cancer. Cancer types with RET amplification included non-small-cell lung cancer (NSCLC), hepatobiliary cancer, prostate cancer, breast cancer, and others. The median RET copy number in RET-amplified cases was 7.5 (range, 6-36) in the DFCI cohort and 5.7 (range, 4-27.7) in the MSKCC cohort. Among 11 RET-amplified NSCLCs, eight had no other concurrent driver mutations. Finally, we report on a 69-year-old man with recurrent NSCLC harboring high-level wild-type RET amplification (22-28 copies) as the only identified putative genomic driver who experienced both a systemic and intracranial confirmed response to the RET inhibitor selpercatinib. CONCLUSIONAmplification of wild-type RET represents a novel, targetable molecular subset of cancer.
Keywords: adenocarcinoma; fusion; efficacy; cell lung-cancer; open-label; phase 1/2; targeting ret; pralsetinib; positive solid tumors; arrow
Journal Title: JCO Precision Oncology
Volume: 7
ISSN: 2473-4284
Publisher: American Society of Clinical Oncology  
Date Published: 2023-09-01
Start Page: e2300295
Language: English
ACCESSION: WOS:001197689200040
DOI: 10.1200/po.23.00295
PROVIDER: wos
PMCID: PMC10681403
PUBMED: 37972337
Notes: Article -- Source: Wos
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MSK Authors
  1. Alexander Edward Drilon
    633 Drilon
  2. Guilherme Harada
    28 Harada
  3. Matteo Repetto
    26 Repetto