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Poster Display session

37P - Pralsetinib in acquired RET fusion-positive advanced non-small cell lung cancer patients after resistance to EGFR/ALK-TKI: A China multi-center, real-world data (RWD) analysis


31 Mar 2023


Poster Display session


Jie Hu


Journal of Thoracic Oncology (2023) 18 (4S): S35-S88.


J. Hu1, X. TANG2, R. Guo3, Y. Wang4, H. Shen5, H. Wang6, Y. Yao7, X. Cai8, Z. Yu9, G. Dong10, F. Liang2, J. Cao11, L. Zeng12, M. Su13, W. Kong14, L. Liu15, W. Huang16, C. Cai17, Y. Xie17, W. Mao18

Author affiliations

  • 1 Shanghai/CN
  • 2 Zhongshan Hospital, Fudan University, Shanghai/CN
  • 3 Jiangsu Province Hospital/The First Affiliated Hospital of Nanjing Medical University, Nanjing/CN
  • 4 The First Affiliated Hospital, Zhejiang University, Hangzhou/CN
  • 5 The Second Hospital of Ningbo, Ningbo/CN
  • 6 The Second Hospital of Tianjin Medical University, 300211 - Tianjin/CN
  • 7 First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an/CN
  • 8 The First Affiliated Hospital of Dalian Medical University, Dalian/CN
  • 9 The Affiliated Hospital of Qingdao University, Qingdao/CN
  • 10 Tangshan People's Hospital, Tangshan/CN
  • 11 YiYand center hospital, Yiyang/CN
  • 12 Hunan Cancer hospital, 410013 - Changsha/CN
  • 13 Shenzhen Bao’an District TCM Hospital, Shenzhen/CN
  • 14 900TH Hospital of Joint Logistics Support Force, Fuzhou/CN
  • 15 1st Affiliated Hospital of Guangxi Medical University, Nanning/CN
  • 16 Ningbo First hospital, Ningbo/CN
  • 17 The first affiliated hospital of Wenzhou Medical college, Wenzhou/CN
  • 18 The Affiliated Jiangyin Hospital of Southeast University Medical College, Wuxi/CN


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Abstract 37P


RET-fusion was reported contribute about 2% of acquired resistance mechanisms of EGFR/ALK-TKIs. Selective RET inhibitor pralsetinib demonstrated impressive improvement of survival in patients with RET+ aNSCLC in the I/II ARROW study. However, the efficacy in patients with acquired RET-fusion after resistance to EGFR/ALK-TKIs was only reported by case, and the strategy of overcome the acquired RET-fusion has not been fully investigated.


This multicenter, retrospective, real-world data analysis enrolled thirty-one aNSCLC with acquired RET-fusion after resistance to EGFR/ALK-TKIs in 23 centers across China from Jan 1st, 2015 to Nov 23rd, 2022. Cohort 1 including 20 patients who received pralsetinib immediately after RET-fusion was detected, of which 15 patients received pralsetinib combined with EGFR/ALK-TKI. Eleven patients who underwent standard chemotherapy in combination with or without immunotherapy or antiangiogenesis therapy on acquired RET+ occurred were enrolled in Cohort 2. Molecular profile, objective response rate (ORR), disease control rate (DCR), progression free survival (PFS), time to treatment failure (TTF), toxicity was assessed.


25.8% (8/31) patients lost EGFR mutation when RET-fusion was detected. EGFR 19del (64.5%) was more likely to develop acquired RET+ compared with L858R mutation (29.0%). CCDC6 was the most common RET-partners (38.7%), followed by KIF5B (19.4%), and NCOA4 (16.1%). In Cohort 1, ORR was 35.0% and DCR was 75.0%, which were higher than Cohort 2 (18.2% and 54.6%, respectively). Patients who received pralsetinib-based therapy had a longer PFS and TTF compared with patients in cohort 2 (PFS: 8.42 months vs. 6.97 months, TTF: 6.48 months vs. 4.24 months). Pralsetinib and EGFR-TKI combination therapy was generally well tolerated, with AEs consistent with known profile of the two drugs.


Pralsetinib-based therapy may be a potential strategy to overcome the acquired RET-fusion after resistance of EGFR/ALK-TKIs.

Legal entity responsible for the study

The authors.


Has not received any funding.


All authors have declared no conflicts of interest.

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