How long does it take on average for platinib (Pujihua) to develop resistance and countermeasures

Pralsetinib is a targeted drug targeting RET fusion-positive non-small cell lung cancer (NSCLC) and other RET-driven tumors. It can significantly inhibit the growth of tumor cells. However, like other targeted therapies, some patients may develop resistance to platinib after long-term use. According to clinical studies and real-world data, resistance to RET inhibitors generally occurs around 12 to 24 months after treatment, but the specific time varies depending on individual patient differences, tumor burden, and gene mutation types.

The mechanisms of drug resistance mainly include the occurrence of secondary RET mutations in tumor cells, activation of alternative signaling pathways (such as MET, KRAS, etc.) and limited drug penetration in tumor tissues. These changes may lead to a decrease in the inhibitory effect of platinib on RET signaling, allowing tumor cells to restore their proliferation and viability. Some patients may have mild tumor progression on imaging examinations in the early stages of drug resistance, but the symptoms are not yet obvious. Therefore, regular imaging follow-up and molecular testing are crucial for early detection of drug resistance.

Measures to deal with platinum resistance include drug dose adjustment, combination therapy, and replacement of other targeted drugs. Clinically, if drug resistance appears early or is accompanied by worsening symptoms, doctors may recommend combination chemotherapy or other targeted drugs to delay disease progression; at the same time, for some patients with secondary mutations, replacement with second-line RET inhibitors that can cover drug-resistant mutations may be considered. Individualized treatment adjustment based on molecular testing results is an important strategy to improve the effectiveness of drug resistance management.

In addition, patients should maintain regular review while taking Platinib, including imaging examinations, tumor marker testing and necessary gene mutation analysis. Once signs of resistance appear, you should communicate with your doctor immediately to evaluate the next treatment plan. At the same time, maintaining good living habits, reasonable diet and moderate exercise in daily life can also help improve body tolerance and delay disease progression. Through scientific management and timely intervention, the impact of platinib resistance can be effectively controlled and the duration of efficacy can be extended to the greatest extent.

Reference link:https://www.drugs.com