TY - JOUR
T1 - RET kinase inhibitors for the treatment of RET-altered thyroid cancers
T2 - Current knowledge and future directions
AU - Hamidi, Sarah
AU - Hu, Mimi I.
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/4
Y1 - 2024/4
N2 - RET gain-of-function mutations are the most common drivers in medullary thyroid carcinoma, while RET fusions are identified in 5–10% of papillary thyroid carcinomas. Thus, RET plays a major role in the tumorigenesis of thyroid neoplasia, making it a valuable therapeutic target. Over a decade ago, multikinase inhibitors (MKIs) were first shown to have variable degrees of anti-RET activity. Despite some clinical efficacy in RET-altered thyroid cancers, significant off-target activity of MKIs led to marked toxicities limiting their use. More recently, two potent, highly selective RET inhibitors, selpercatinib and pralsetinib, were shown to have notable efficacy in RET-altered cancers, associated with more tolerable side effect profiles than those of MKIs. However, these treatments are non-curative, and emerging evidence suggests that patients who progress on therapy acquire mutations conferring drug resistance. Thus, the quest for a more definitive treatment for advanced, RET-altered thyroid cancers continues. This year we celebrate the 30th anniversary of the association of germline mutations of the RET proto-oncogene with the multiple endocrine neoplasia (MEN) type 2 syndromes. In this timely review, we summarize the current state-of-the-art treatment strategies for RET-altered thyroid cancers, their limitations, as well as future therapeutic avenues.
AB - RET gain-of-function mutations are the most common drivers in medullary thyroid carcinoma, while RET fusions are identified in 5–10% of papillary thyroid carcinomas. Thus, RET plays a major role in the tumorigenesis of thyroid neoplasia, making it a valuable therapeutic target. Over a decade ago, multikinase inhibitors (MKIs) were first shown to have variable degrees of anti-RET activity. Despite some clinical efficacy in RET-altered thyroid cancers, significant off-target activity of MKIs led to marked toxicities limiting their use. More recently, two potent, highly selective RET inhibitors, selpercatinib and pralsetinib, were shown to have notable efficacy in RET-altered cancers, associated with more tolerable side effect profiles than those of MKIs. However, these treatments are non-curative, and emerging evidence suggests that patients who progress on therapy acquire mutations conferring drug resistance. Thus, the quest for a more definitive treatment for advanced, RET-altered thyroid cancers continues. This year we celebrate the 30th anniversary of the association of germline mutations of the RET proto-oncogene with the multiple endocrine neoplasia (MEN) type 2 syndromes. In this timely review, we summarize the current state-of-the-art treatment strategies for RET-altered thyroid cancers, their limitations, as well as future therapeutic avenues.
KW - Multikinase inhibitor
KW - Neoadjuvant
KW - RET
KW - RET inhibitor
KW - RET-altered thyroid cancer
KW - Resistance mechanisms
UR - http://www.scopus.com/inward/record.url?scp=85186239548&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85186239548&partnerID=8YFLogxK
U2 - 10.1016/j.ando.2024.02.001
DO - 10.1016/j.ando.2024.02.001
M3 - Review article
C2 - 38342224
AN - SCOPUS:85186239548
SN - 0003-4266
VL - 85
SP - 118
EP - 126
JO - Annales d'endocrinologie
JF - Annales d'endocrinologie
IS - 2
ER -