Selperctinib as neoadjuvant therapy for RET-altered papillary thyroid carcinoma: Two case reports.

[BACKGROUND] Locally advanced papillary thyroid carcinoma (PTC) with RET fusion-positive poses significant challenges for surgical resection due to tumor invasion into critical structures. Neoadjuvant targeted therapies are a promising approach to reduce the tumor burden and improve the resectability. Selperctinib, a RET kinase inhibitor, has been approved for the treatment of advanced or metastatic RET-altered thyroid cancer. However, the efficacy of selperctinib as a neoadjuvant treatment for locally advanced RET-altered thyroid cancer is unclear.

[CASE PRESENTATION] We report two cases of RET fusion-positive PTC that received neoadjuvant treatment with selperctinib (160 mg twice daily) to reduce the tumor size and enable for radical resection. Tumor sizes were reduced after neoadjuvant treatment with selperctinib. Patients successfully underwent R0 resection with no major surgical complications.

[CONCLUSION] Selperctinib isa potential neoadjuvant treatment for PTC with RET fusion-positive.