Tianle Shen1, Xingxiang Pu2, Liping Wang3, Zongyang Yu4, Jinluan Li5, Yinbin Zhang6, Xianbin Liang7, Huafei Chen8, Chunwei Xu9, Zhengbo Song10, Wenxian Wang11. 1. Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai, China. 2. Department of Medical Oncology, Hunan Cancer Hospital, Hunan, China. 3. Department of Medical Oncology, Baotou Cancer Hospital, Baotou, China. 4. Department of Medical Oncology, The 900th Hospital of People's Liberation Army, Fuzhou, China. 5. Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China. 6. Department of Medical Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. 7. Department of Medical Oncology, The Third Hospital of Zhengzhou, Zhengzhou, China. 8. Department of Medical Oncology, Zhejiang Rongjun Hospital, Jiaxing, China. 9. Department of Pathology, Fujian Cancer Hospital, Fujian Medical University, Fujian, China. 10. Department of Medical Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Banshan National Park Forest, China; Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China. Electronic address: zjzlyy16@163.com. 11. Department of Medical Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Banshan National Park Forest, China; Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China. Electronic address: helen-0407@163.com.
Abstract
BACKGROUND: Rearranged during transfection (RET) proto-oncogene gene fusions are rare in non-small-cell lung cancer (NSCLC). We compared the efficacy of pemetrexed-based chemotherapy with other chemotherapy regimens in patients with NSCLC with different RET fusion subtypes. PATIENTS AND METHODS: A retrospective, multicenter study of patients with pathologically confirmed stage IIIB/IV lung adenocarcinomas was conducted. RET rearrangements were detected using next generation sequencing. We analyzed the clinical characteristics of patients with RET-rearranged NSCLC and the efficacy of chemotherapy regimens. We also evaluated the efficacy between groups of patients with and without KIF5B-RET-rearranged lung cancer. RESULTS: We evaluated 62 patients with NSCLC and RET rearrangements, including 41 with KIF5B-RET, 15 with CCDC6-RET, and 6 with other rare fusion subtypes. Of these 62 patients, 50 had stage IIIB/IV. We also evaluated 40 patients with first-line chemotherapy information available. The median progression-free survival was significantly different between those receiving pemetrexed-based chemotherapy and those receiving other chemotherapy regimens (9.2 vs. 5.2 months; P = .007). The median progression-free survival for patients with KIF5B-RET fusion and non-KIF5B-RET fusion was not significantly different statistically (7.8 vs. 11.2 months; P = .847). For second-line chemotherapy, a statistically significant difference was found between the chemotherapy regimens (4.9 vs. 2.8 months; P = .049). Survival follow-up data were available for 38 patients with advanced NSCLC. The median overall survival was 26.4 months. The overall survival of the patients with RET-rearranged NSCLC who had received pemetrexed-based chemotherapy versus no pemetrexed-based chemotherapy was 35.2 versus 22.6 months (P = .052). No difference in survival was observed between the patients with KIF5B-RET and non-KIF5B-RET rearrangements. CONCLUSIONS: Pemetrexed-based treatment should be considered first when selecting the chemotherapy regimen for patients with NSCLC and RET rearrangements.
BACKGROUND:Rearranged during transfection (RET) proto-oncogene gene fusions are rare in non-small-cell lung cancer (NSCLC). We compared the efficacy of pemetrexed-based chemotherapy with other chemotherapy regimens in patients with NSCLC with different RET fusion subtypes. PATIENTS AND METHODS: A retrospective, multicenter study of patients with pathologically confirmed stage IIIB/IV lung adenocarcinomas was conducted. RET rearrangements were detected using next generation sequencing. We analyzed the clinical characteristics of patients with RET-rearranged NSCLC and the efficacy of chemotherapy regimens. We also evaluated the efficacy between groups of patients with and without KIF5B-RET-rearranged lung cancer. RESULTS: We evaluated 62 patients with NSCLC and RET rearrangements, including 41 with KIF5B-RET, 15 with CCDC6-RET, and 6 with other rare fusion subtypes. Of these 62 patients, 50 had stage IIIB/IV. We also evaluated 40 patients with first-line chemotherapy information available. The median progression-free survival was significantly different between those receiving pemetrexed-based chemotherapy and those receiving other chemotherapy regimens (9.2 vs. 5.2 months; P = .007). The median progression-free survival for patients with KIF5B-RET fusion and non-KIF5B-RET fusion was not significantly different statistically (7.8 vs. 11.2 months; P = .847). For second-line chemotherapy, a statistically significant difference was found between the chemotherapy regimens (4.9 vs. 2.8 months; P = .049). Survival follow-up data were available for 38 patients with advanced NSCLC. The median overall survival was 26.4 months. The overall survival of the patients with RET-rearranged NSCLC who had received pemetrexed-based chemotherapy versus no pemetrexed-based chemotherapy was 35.2 versus 22.6 months (P = .052). No difference in survival was observed between the patients with KIF5B-RET and non-KIF5B-RET rearrangements. CONCLUSIONS:Pemetrexed-based treatment should be considered first when selecting the chemotherapy regimen for patients with NSCLC and RET rearrangements.