PMID- 37492479
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230727
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 13
DP  - 2023
TI  - Small bowel edema and lymphocytic duodenitis as severe reversible 
      gastrointestinal toxicity of selpercatinib in RET fusion-positive non-small cell 
      lung cancer: a case report.
PG  - 1201599
LID - 10.3389/fonc.2023.1201599 [doi]
LID - 1201599
AB  - INTRODUCTION: Rearranged during transfection (RET) gene rearrangements occur in 
      1%-2% of non-small cell lung cancer (NSCLC). Because of the results of the study 
      LIBRETTO-001, selpercatinib has been approved as the first-line treatment for 
      patients with RET fusion-positive advanced NSCLC. Selpercatinib demonstrated to 
      be well tolerated. Despite this, gastrointestinal adverse events (AEs) are 
      frequently reported, and no clinical-radiological and endoscopic features and 
      their impact in terms of treatment discontinuations, interruptions, and dose 
      reductions have been described so far. CASE REPORT: A 37-year-old never-smoker 
      woman was treated in our institution with selpercatinib for a RET fusion-positive 
      NSCLC. After 9 months of treatment, the patient referred abdominal pain of grade 
      (G) 2, associated with nausea of G2, bilious vomiting of G3, and weight loss of 
      G1. At computed tomography scan, the presence of important bowel wall thickening, 
      free ascitic fluid, mesenteric congestion, and stranding was detected. The 
      patient underwent an anterograde enteroscopy extended to jejunum with detection 
      of lymphocytic duodenitis with sub-mucosal edema. Selpercatinib treatment was 
      temporary interrupted with complete resolution of the symptoms and then 
      re-administered with dose reduction, without relapsed of the gastrointestinal 
      toxicity after 120 days. CONCLUSION: To our knowledge, this is the first case 
      report of a patient with NSCLC treated with selpercatinib outside a clinical 
      study who developed severe gastrointestinal toxicity characterized by small bowel 
      edema and lymphocytic duodenitis, leading to treatment interruption and dose 
      reduction. The gastrointestinal AE has been described by a radiological, 
      endoscopic, and histopathological point of view. Further investigations are 
      needed to better identify pathological mechanisms of gastrointestinal toxicity 
      for an appropriate AE management.
CI  - Copyright (c) 2023 Scattolin, Scagliori, Scapinello, Fantin, Guarneri and Pasello.
FAU - Scattolin, Daniela
AU  - Scattolin D
AD  - Medical Oncology 2, Veneto Institute of Oncology (IOV), IRCCS, Padova, Italy.
AD  - Department of Surgery, Oncology and Gastroenterology, University of Padova, 
      Padova, Italy.
FAU - Scagliori, Elena
AU  - Scagliori E
AD  - Radiology Unit, Veneto Institute of Oncology (IOV), IRCCS, Padova, Italy.
FAU - Scapinello, Antonio
AU  - Scapinello A
AD  - Pathology Unit, Veneto Institute of Oncology (IOV), IRCCS, Padova, Italy.
FAU - Fantin, Alberto
AU  - Fantin A
AD  - Gastroenterology Unit, Veneto Institute of Oncology (IOV), IRCCS, Padova, Italy.
FAU - Guarneri, Valentina
AU  - Guarneri V
AD  - Medical Oncology 2, Veneto Institute of Oncology (IOV), IRCCS, Padova, Italy.
AD  - Department of Surgery, Oncology and Gastroenterology, University of Padova, 
      Padova, Italy.
FAU - Pasello, Giulia
AU  - Pasello G
AD  - Medical Oncology 2, Veneto Institute of Oncology (IOV), IRCCS, Padova, Italy.
AD  - Department of Surgery, Oncology and Gastroenterology, University of Padova, 
      Padova, Italy.
LA  - eng
PT  - Case Reports
DEP - 20230710
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC10363725
OTO - NOTNLM
OT  - NSCLC
OT  - RET
OT  - gastrointestinal toxicity
OT  - selpercatinib
OT  - small bowel
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/07/26 06:43
MHDA- 2023/07/26 06:44
PMCR- 2023/01/01
CRDT- 2023/07/26 03:52
PHST- 2023/04/06 00:00 [received]
PHST- 2023/06/20 00:00 [accepted]
PHST- 2023/07/26 06:44 [medline]
PHST- 2023/07/26 06:43 [pubmed]
PHST- 2023/07/26 03:52 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2023.1201599 [doi]
PST - epublish
SO  - Front Oncol. 2023 Jul 10;13:1201599. doi: 10.3389/fonc.2023.1201599. eCollection 
      2023.