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[pick list]
[Dear]
[Hello]
[pick list]
[Dr. Last Name],
[First Name],
[First Name Last Name],
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[pick list]
[I wanted to reach out and share some helpful information around the importance of testing for actionable biomarkers in mNSCLC, including RET.]
[I appreciate that your time is valuable. When you're available, I'd like to speak with you about the importance of testing for all biomarkers, like RET, and using biomarker test results to inform treatment decisions in mNSCLC.]
[Thank you so much for taking time out of your busy day to speak with me. Below is a recap of our discussion around the importance of biomarker testing in mNSCLC.]
[I hope you're doing well. I wanted to check in and see how things are going. Below is some information you might find helpful regarding the importance of biomarker testing in mNSCLC.]
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The importance of obtaining complete biomarker test
results prior to initiating first-line therapy in mNSCLC
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Insufficient tissue (or QNS) is not a conclusive result. Consider retesting to determine if a biomarker is present.1
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About 1 in 2 patients with
mNSCLC have biomarkers
with approved, emerging, or
evolving therapeutics2,3
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RET fusions are 1 of 8 driver alterations with FDA-approved therapies2,3
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In pivotal studies, patients with RET+ mNSCLC have been shown to respond to RET inhibitors across all lines of therapy, including first-line4
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Ensure you review all biomarker test results before making therapeutic decisions2,4
Emerging Therapeutics=currently being studied in clinical trials; Evolving Therapeutics=either proof-of-concept studies or in very early clinical stage.
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Although many mNSCLC patients have derived benefit from immunotherapy (IO), some biomarker-driven cancers may respond poorly to IO treatment5-8
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mNSCLC patients with biomarkers are often excluded from IO clinical trials6,9
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In a retrospective study of 551 advanced NSCLC patients, IO response rates in select biomarker-driven NSCLC were5:
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– ALK (n=23): 0%
– BRAF (n=43): 24%
– EGFR (n=125): 12%
– KRAS (n=271): 26%
– MET (n=36): 16%
– RET (n=16): 6%
– ROS1 (n=7): 17%
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Before administering first-line immunotherapy, consider these recommendations from NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer1:
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Across all PD-L1 expression levels, the guidelines recommend that patients are negative for actionable molecular markers before utilizing immunotherapy as a first-line treatment option for mNSCLC*
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Contraindications for treatment with PD-1/PD-L1 inhibitors in patients with advanced or metastatic NSCLC may include the presence of oncogenes (such as EGFR, ALK, and RET), which would predict a lack of benefit
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*The NCCN Guidelines® for NSCLC provide recommendations for certain individual biomarkers that should be tested and recommend testing techniques but do not endorse any specific commercially available biomarker assays or commercial laboratories.
See the NCCN Guidelines® for NSCLC for detailed recommendations, including preferred treatment options. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
ALK=anaplastic lymphoma kinase; BRAF=B-Raf proto-oncogene; EGFR=epidermal growth factor receptor; ERBB2=receptor tyrosine kinase ErbB2 (human EGF receptor 2 or HER2); KRAS=Kirsten rat sarcoma; MET=MET proto-oncogene; mNSCLC=metastatic non–small cell lung cancer; NCCN®=National Comprehensive Cancer Network®; NTRK=neurotrophic tyrosine receptor kinase; PD-1=programmed cell-death protein 1; PD-L1=programmed death-ligand 1; QNS=quantity not sufficient; RET=rearranged during transfection; ROS1=ROS proto-oncogene 1.
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Test for all biomarkers in mNSCLC.
Click here to learn more about a RET inhibitor.
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[Fragment/attachment pick list]
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I've included some information I hope you'll find useful.
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Biomarker Testing and Treatment Initiation Flashcard
Overview of biomarker testing in mNSCLC and using results to inform treatment decisions.
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I'm available in person or virtually to answer any questions you may have.
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[pick list]
[Sincerely,]
[Best,]
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[Rep photo]
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[pick list]
[Rep name]
[Rep title]
Blueprint Medicines
[Rep phone number]
[Rep email address]
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References: 1. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.5.2021. National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed July 7, 2021. To view the most recent and complete version of the guideline, go online to NCCN.org. 2. VanderLaan PA, Rangachari D, Costa DB. The rapidly evolving landscape of biomarker testing in non–small cell lung cancer. Cancer Cytopathol. 2021;129(3):179-181. 3. US Food and Drug Administration. https://www.fda.gov/drugs/drug-approvals-and-databases/fda-grants-accelerated-approval-sotorasib-kras-g12c-mutated-nsclc. Accessed June 2, 2021. 4. Drusbosky LM, Rodriguez E, Dawar R, Ikpeazu CV. Therapeutic strategies in RET gene rearranged non-small cell lung cancer. J Hematol Oncol. 2021;14(50):1-8. 5. Mazières J, Drilon A, Lusque A, et al. Immune checkpoint inhibitors for patients with advanced lung cancer and oncogenic driver alterations: results from the IMMUNOTARGET registry. Ann Oncol. 2019;30(8):1321-1328. 6. Addeo A, Passaro A, Malapelle U, Banna GL, Subbiah V, Friedlaender A. Immunotherapy in non-small cell lung cancer harbouring driver mutations. Cancer Treat Rev. 2021;96:102179. doi:10.1016/j.ctrv.2021.102179. 7. Chen R, Tao Y, Xu X, et al. Discov Med. 2018;26(143):155-166. 8. Lisberg A, Cummings A, Goldman JW, et al. J Thorac Oncol. 2018;13(8):1138-1145. 9. Offin M, Guo R, Wu SL, et al. Immunophenotype and response to immunotherapy of RET-rearranged lung cancers. JCO Precis Oncol. 2019;3:PO.18.00386. doi:10.1200/PO.18.00386.
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