CASE REPORT article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1546287
Effective treatment of non-fusion RET intragenic deletion lung adenocarcinoma with Pralsetinib: a case report
Provisionally accepted
- Second Affiliated Hospital of Nanchang University, Nanchang, China
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RET fusions, the most common oncogenic RET alterations, occur in approximately 1%-2% of non-small cell lung cancer (NSCLC) cases and represent well-established therapeutic targets.[1]. Pralsetinib, a selective RET kinase inhibitor, has demonstrated significant efficacy and tolerability in patients with RET fusion-positive NSCLC. However, the clinical management of NSCLC with non-fusion RET structural variants remains challenging. Here, we report a case of a middle-aged male diagnosed with stage IV lung adenocarcinoma, in whom initial next-generation sequencing (NGS) revealed no actionable mutations. The patient achieved a partial response to pemetrexed and platinum-based chemotherapy, but disease progression occurred nine months later. Upon re-biopsy, a large intragenic RET deletion involving exons 2–11 was detected. Based on this finding, the patient was treated with pralsetinib and achieved radiological tumor regression, with a progression-free survival of five months to date. This case highlights a potential therapeutic role for RET inhibitors even in the absence of canonical fusions, and underscores the importance of reassessing the tumor’s molecular profile following treatment failure, as acquired genomic alterations may provide new targets for precision therapy.
Keywords: Intragenic RET deletion, Lung Adenocarcinoma, Pralsetinib, nextgeneration sequencing, Targeted Therapy Intragenic RET deletion, targeted therapy
Received: 16 Dec 2024; Accepted: 02 Jun 2025.
Copyright: © 2025 Li, Zhu, Yang, Tian, Cao and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lirong He, Second Affiliated Hospital of Nanchang University, Nanchang, China
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