ESMO 2020: Influence of Selpercatinib on Diarrhea in Patients With Medullary Thyroid Cancer
Posted: Tuesday, October 13, 2020
Patients with medullary thyroid cancer typically have diarrhea, with moderate to high severity at baseline; however, treating thyroid cancer with the RET inhibitor selpercatinib appeared to reduce the rate and severity of diarrhea significantly. Lori J. Wirth, MD, of Massachusetts General Hospital and Harvard Medical School, Boston, presented this work on behalf of her colleagues at the European Society for Medical Oncology (ESMO) Virtual Congress 2020 (Abstract 1922P).
The phase I/II LIBRETTO-001 trial enrolled patients with medullary thyroid cancer, and all were treated with twice daily oral selpercatinib in 28-day cycles. Patients completed the European Organisation for the Research and Treatment of Cancer Quality-of-Life Questionnaire (QLQ)-C30 and the modified Systemic Therapy-Induced Diarrhea Assessment Tool (mSTIDAT). The QLQ-C30 was completed at baseline and approximately every 8 weeks until the end of the study. Subscales of the QLQ-C30 are rated from 1 to 100, with higher scores indicating better functioning or more severe symptoms. A clinically meaningful difference in quality of life was defined as a greater than 10-point change in the QLQ-C30 score from baseline.
At baseline, the 192 patients who completed the QLQ-C30 had a mean score of 40.1. These scores reduced by –23.2 at cycle 3, –27.1 at cycle 5, –27.9 at cycle 7, –26.5 at cycle 9, and –25.6 at cycle 11. Additionally, 80.5% of the 123 patients who completed the mSTIDAT reported having diarrhea at baseline, with 48.5% of patients reporting moderate diarrhea and 25.3% reporting severe diarrhea. By the third treatment cycle with selpercatinib, 53.2% of patients with baseline diarrhea reported having no diarrhea. The remaining 46.8% of patients with baseline diarrhea saw improvements as well, as 70.3% of these patients said the diarrhea was minimal. Overall, researchers saw that more than 80% of enrolled patients who had diarrhea at baseline reported a reduction in diarrhea during treatment with selpercatinib.
Disclosure: For a full list of author disclosures, visit oncologypro.esmo.org.