RET Inhibitor
Selpercatinib
- Type of Alteration(s)Point Mutations*Alteration(s) of Interest †RET M918T
Methodology
Key Considerations
Sanger Sequencing- Lower sensitivity than NGS for somatic alterations, thus more suitable for germline testing in MTC
- Detection may require higher tumor content than PCR-based assays
PCR-based- Selected assay should have full coverage of exons 8, 10, 11 and 13-16
NGS (Tissue)- Suitable for broad-based genomic profiling that includes targets in addition to RET
NGS (cfDNA)- Useful when tissue biopsy sample is limited/unavailable
- Higher false negative rate than tissue-based NGS testing
*Point mutations occur in MTC, and gene fusions occur in PTC and NSCLC†List is not exhaustive of all activating alterationsReferences
- Mulligan LM. Nat Rev Cancer. 2014;14(3):173-186.
- Drilon A, et al. Nat Rev Clin Oncol. 2018;15(3):151-167.
- Type of Alteration(s)Gene fusions*Alteration(s) of Interest †KIF5B-RET
CCDC6-RET
NCOA4-RETMethodology
Key Considerations
NGS (cfDNA)- Useful when tissue biopsy sample is limited/unavailable
- Higher false negative rate than tissue-based NGS testing
Sanger Sequencing- Lower sensitivity than NGS for somatic alterations, thus more suitable for germline testing in MTC
- Detection may require higher tumor content than PCR-based assays
NGS (Tissue)- Suitable for broad-based genomic profiling that includes targets in addition to RET
- RNA-based NGS is most suitable for fusions
PCR-based- Will detect known fusions but may miss novel RET rearrangements
- Selected assay should have full coverage of exons 8, 10, 11 and 13-16
FISH- Lack of standard cutoffs to define positivity
- Close proximity of common fusion partners can complicate analysis
- Cannot determine if fusion results in functional protein, leading to false positives
*Gene fusions occur in PTC and NSCLC, point mutations occur in MTC†List is not exhaustive of all activating alterationsReferences
- Mulligan LM. Nat Rev Cancer. 2014;14(3):173-186.
- Drilon A et al. Nat Rev Clin Oncol 15:151-167, 2018
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