Retevmo: What You Need to Know About Its Use and Safety

Indications:

Retevmo (selpercatinib) is an oral kinase inhibitor designed for the treatment of specific types of cancers. Its primary indications include:

Non-Small Cell Lung Cancer (NSCLC): Retevmo is approved for adult patients with metastatic NSCLC who have RET gene fusions. These genetic alterations can drive the growth of cancer, and targeting them can help slow disease progression.

Medullary Thyroid Cancer (MTC): Retevmo is used for adult and pediatric patients (12 years and older) with advanced or metastatic MTC with a RET mutation. This targeted therapy offers an important option for patients whose cancer is driven by these genetic changes.

Thyroid Cancer: It is also approved for adult and pediatric patients (12 years and older) with advanced or metastatic RET fusion-positive thyroid cancer who require systemic therapy and have progressed following prior treatment.

Solid Tumors: This therapeutic drug used for the treatment of adult and pediatric patients aged 2 years and older with locally advanced or metastatic solid tumors.

Warnings:

Hepatotoxicity: Retevmo can cause elevated liver enzymes (ALT and AST), which may indicate liver damage. Liver function tests should be conducted before starting treatment and monitored periodically during therapy. Dose adjustments or discontinuation may be necessary if severe liver toxicity occurs.

Hypertension: Treatment with Retevmo can lead to elevated blood pressure. Blood pressure should be well controlled prior to initiating treatment, and it should be monitored regularly. If hypertension is severe, dose modifications or antihypertensive medications may be required.

QT Interval Prolongation: Retevmo has the potential to prolong the QT interval, which can lead to serious cardiac arrhythmias. Electrocardiograms (ECGs) and electrolytes should be monitored periodically. Patients with congenital long QT syndrome should avoid using Retevmo.

Hemorrhagic Events: Serious bleeding events, including fatal hemorrhages, can occur. Patients with a history of significant bleeding disorders should be carefully evaluated before starting treatment. Close monitoring for signs of bleeding is essential.

Hypersensitivity Reactions: Hypersensitivity reactions, including severe and potentially fatal anaphylaxis, have been reported. Immediate discontinuation of Retevmo and appropriate medical intervention are required if hypersensitivity occurs.

Wound Healing Complications: Selpercatinib may impair wound healing. Treatment should be paused before elective surgery and resumed based on clinical judgment post-surgery.

Embryo-Fetal Toxicity: This therapeutic drug can cause fetal harm when administered to pregnant women. Females of reproductive potential should be advised to use effective contraception during treatment and for one week after the last dose. Men with female partners of reproductive potential should also use effective contraception.

Conclusion: Retevmo (selpercatinib) represents a significant advancement in targeted cancer therapy for patients with RET-driven cancers. While it offers substantial benefits, healthcare providers and patients must be vigilant about the potential risks associated with its use. Regular monitoring and adherence to recommended precautions can help mitigate these risks and optimize treatment outcomes. Always consult a healthcare provider for personalized medical advice before starting any new treatment.