Selpercatinib versus multi-kinase inhibitors for advanced medullary thyroid cancer: A network meta-analysis of RET-targeted therapies - Report - MDSpire

Selpercatinib versus multi-kinase inhibitors for advanced medullary thyroid cancer: A network meta-analysis of RET-targeted therapies

  • By

  • Jiazhong Wang

  • Gang Cao

  • Yang Liu

  • Hao Qiao

  • Qiao He

  • Bo Zheng

  • June 22, 2026

  • 0 min

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Clinical Report: Comparative Efficacy of Selpercatinib in Advanced MTC

Overview

This network meta-analysis evaluates the efficacy and safety of selpercatinib compared to multi-kinase inhibitors (MKIs) in advanced medullary thyroid cancer (MTC).

Background

Medullary thyroid cancer (MTC) is a rare neuroendocrine tumor primarily driven by RET mutations. RET-targeted therapies are crucial for treatment. Selective RET inhibitors like selpercatinib may offer advantages over traditional multi-kinase inhibitors, which often have significant off-target toxicities.

Data Highlights

OutcomeSelpercatinibCabozantinibVandetanib
PFS (HR)0.10 (95% CI: 0.05–0.18)0.280.46
ORR (OR)122.6 (95% CI: 34.5–435.6)N/AN/A
≥Grade 3 AEs (OR)1.34N/AN/A
Hepatotoxicity (OR)4.20N/AN/A
Toxicity (Anlotinib)12.00N/AN/A

Key Findings

  • Selpercatinib demonstrated a significant PFS benefit compared to MKIs.
  • It ranked first for ORR among the evaluated treatments.
  • Selpercatinib showed no significant difference in ≥Grade 3 AEs compared to placebo.
  • Anlotinib exhibited the highest toxicity among the agents studied.
  • Selpercatinib was associated with hepatotoxicity.

Clinical Implications

Clinical decisions should consider individual patient characteristics and the heterogeneity of RET mutation status.

Conclusion

This network meta-analysis demonstrates that selpercatinib exhibits superior efficacy and a more favorable safety profile compared to MKIs for advanced MTC.

Related Resources & Content

  1. The ASCO Post, Advanced RET-Mutant Medullary Thyroid Cancer: First-Line Selpercatinib KEY POINTS, 2023 -- https://ascopost.com/news/november-2023/advanced-ret-mutant-medullary-thyroid-cancer-first-line-selpercatinib?TRILIBIS_EMULATOR_UA=Mozilla%2f5.0+(Windows+NT+6.1%3b+Win64%3b+x64%3b+rv%3a57.0)+Gecko%2f20100101+Firefox%2f57.0
  2. The ASCO Post, Selpercatinib Makes Inroads in Other RET Fusion–Positive Tumor Types, 2021 -- https://ascopost.com/issues/may-25-2021/selpercatinib-makes-inroads-in-other-ret-fusion-positive-tumor-types/
  3. ENDOCAN-TUTHYREF network consensus recommendations. Refractory medullary thyroid cancer - ScienceDirect -- https://www.sciencedirect.com/science/article/pii/S0003426625000526
  4. The ASCO Post — LIBRETTO-431 Trial Shows Selpercatinib Is Effective in East Asian Patients With RET Fusion–Positive Non–Small Cell Lung Cancer KEY POINTS
  5. The ASCO Post — FDA Approves Selpercatinib for RET Fusion–Positive Medullary Thyroid Cancer
  6. ENDOCAN-TUTHYREF network consensus recommendations. Refractory medullary thyroid cancer - ScienceDirect
  7. Cabozantinib in progressive medullary thyroid cancer - PubMed
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Original Source(s)

Selpercatinib versus multi-kinase inhibitors for advanced medullary thyroid cancer: A network meta-analysis of RET-targeted therapies

  • by Jiazhong Wang, Gang Cao, Yang Liu, Hao Qiao, Qiao He, Bo Zheng

  • June 22, 2026

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