Test for RET in mNSCLC

Talk to your pathologist or lab partners to determine how to best test comprehensively for all biomarkers in mNSCLC, including RET

Comprehensive biomarker testing can assess most actionable biomarkers with one test—so you can identify which biomarker may be responsible for driving disease6

The National Comprehensive Cancer Network® (NCCN®) NSCLC Panel recommends that eligible patients with metastatic NSCLC receive routine biomarker testing for2:

  • EGFR mutations
  • ALK fusions
  • ROS1 fusions
  • BRAF mutations
  • HER2 (ERBB2) mutations
  • KRAS G12C mutations
  • METex14 skipping mutations
  • RET rearrangements
  • NTRK1/2/3 gene fusions
  • PD-L1 expression levels

ALK=anaplastic lymphoma kinase; BRAF=B-Raf proto-oncogene; EGFR=endothelial growth factor receptor; KRAS=Kirsten rat sarcoma; MET=MET proto-oncogene; mNSCLC=metastatic non–small cell lung cancer; NTRK=neurotrophic tyrosine receptor kinase; PD-L1=programmed death-ligand 1; RET+=rearranged during transfection positive; ROS1=ROS proto-oncogene 1.

Insufficient tissue (or QNS) is not a conclusive result and may lead to an uninformed treatment decision2

NGS-based tissue genotyping and plasma ctDNA testing are considered accurate, reliable, and complementary approaches to test for actionable biomarkers, including RET alterations.7

  • Testing of plasma ctDNA may overcome some of the limitations of tumor tissue genotyping due to faster turnaround time and a less invasive procedure7
  • Plasma ctDNA testing is recommended by both IASLC and NCCN under certain circumstances2,7

IASLC Guidelines7

Plasma ctDNA can now be considered a valid tool for genotyping of newly diagnosed patients with advanced NSCLC and should be performed using a clinically validated NGS platform

NCCN Clinical Practice Guidelines in Oncology

NCCN Guidelines® recommend plasma ctDNA testing as an option when there is limited tissue availability or the patient is unfit for invasive tissue sampling

Use biomarker test results to help guide treatment decisions in mNSCLC4,8,9

Reviewing biomarker test results before initiating treatment could help determine an appropriate treatment plan9

targeted therapy

Targeted therapies may lead to better outcomes in patients with actionable biomarkers.9-12

  • Although many mNSCLC patients have derived benefit from immunotherapy (IO), some biomarker-driven cancers may respond poorly to IO treatment13-16
    • mNSCLC patients with biomarkers are often excluded from IO clinical trials14,17
    • In a retrospective study of 551 advanced NSCLC patients, IO response rates in select biomarker-driven NSCLC were13:
      • ALK (n=23): 0%
      • RET (n=16): 6%
      • EGFR (n=125): 12%
      • HER2 (ERBB2) (n=29): 7%
      • KRAS (n=271): 26%
      • BRAF (n=43): 24%
      • ROS1 (n=7): 17%
      • MET (n=36): 16%
NCCN Guidelines

NCCN Guidelines state that, for eligible patients with metastatic NSCLC who have actionable genetic variants, targeted therapy2:

  • is recommended as a first-line and/or second-line treatment option, depending on the biomarker*
  • for the oncogenic driver should take precedence over treatment with an immune checkpoint inhibitor, even when PD-L1 expression is elevated in patients with an oncogenic driver

*Targeted therapy is recommended as second-line treatment for KRAS G12C, EGFR exon 20, and HER2 (ERBB2) mutations.

DNA Icon

Select patients for treatment based on the presence of a RET gene fusion. Consider a selectively designed RET inhibitor.1

Information on FDA-approved tests for RET gene fusions is available at http://www.fda.gov/​CompanionDiagnostics

Contact a Representative
Contact a representative

Contact your local representative for more information about RET in mNSCLC.