Objective:

To evaluate the relative efficacy and safety of RET-targeted agents for advanced medullary thyroid cancer (MTC) via network meta-analysis.

Approach:

Key Findings:

• Selpercatinib showed the most significant PFS benefit (HR = 0.10, 95% CI: 0.05–0.18; P-score = 0.999).
• Selpercatinib ranked first for ORR (OR = 122.6, 95% CI: 34.5–435.6).
• Selpercatinib had no significant difference in ≥Grade 3 AEs compared to placebo (OR = 1.34).
• Anlotinib exhibited the highest toxicity (OR = 12.00).
• Selpercatinib was associated with hepatotoxicity (OR = 4.20) but avoided off-target toxicities typical of MKIs.

Interpretation:

Selpercatinib demonstrates superior efficacy and a more favorable safety profile compared to multi-kinase inhibitors for advanced MTC.

Limitations:

• Heterogeneity of included populations with mixed RET mutation status and therapy lines.

Conclusion:

Selpercatinib is supported as a recommended first-line option for advanced MTC.

Sources:

• Systematic Review Registration
Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.