What should I do if I become resistant to Selpercatinib?

Selpercatinib has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of metastatic RET fusion-positive non-small cell lung cancer (NSCLC), advanced/metastatic RET-altered medullary thyroid carcinoma (MTC), and papillary thyroid carcinoma. Compared with other multikinase inhibitors, selpercatinib is considered to have a better safety profile.

Patients with locally advanced or metastatic solid tumors received 160 mg of serpatinib twice daily, reaching steady state after approximately 7 days, with a Cmax of 2980 and an AUC0-24h of 51,600. Absolute bioavailability is between 60% and 82%, with an average tmax of two hours. Food has no significant effect on the AUC or Cmax of serpatinib. AUC0-INF increased simultaneously in patients with hepatic impairment for mild (7%), moderate (32%), and severe (77%) hepatic impairment. Eight percent of patients receiving serpatinib permanently discontinued treatment due to adverse reactions, including increased alanine aminotransferase, fatigue, sepsis, and increased aspartate aminotransferase. Everyone’s constitution is different and their resistance to drugs is also different. If you feel unwell, please inform your doctor in time.

The original drug Serpatinib has not yet been launched in China, so it is not covered by medical insurance. Domestic patients cannot yet purchase this drug. Serpatinib marketed overseas The original drug has a US version and a European version. The price of the US version is about 150,000 yuan per box of 80mg*60 pills. The price of the European version of 80mg*56 pills per box is about 21,000 yuan (the price may fluctuate due to the exchange rate), which is expensive. There are also serpatinibgeneric drugs produced abroad. The specification produced by a Bangladesh pharmaceutical factory is 40mg*30 pills per box and the price is about 4,300 yuan (the price may fluctuate due to the exchange rate). The ingredients of the generic drugs are basically the same as those of the original drug.