RETEVMO For Thyroid Cancer


WARREN, Ohio. (Ivanhoe Newswire)— September is Thyroid Cancer Awareness Month. Ninety percent of all patients are cured if it’s caught early. But for those with medullary thyroid cancer, a rare form of the disease, there have been few effective options. Now, introducing the first young man in the country who is being treated with a life-saving drug, which was at first, prescribed for adults only.

Twenty-year old Tanner Noble looks healthy and fit teeing off with his mom Demetra and dad, Robert. But for five of the last six years, Tanner has been fighting for his life. The first sign of sickness was rapid weight loss during his freshman year football season.

“The beginning of the season, I was about 130 and by about halfway, I was already at 115,” Tanner recalled.

Doctors couldn’t find the cause. After a year of specialists and tests, doctors finally found cancer that had spread.

“It was in his lungs; it was in his spine. It was in his femur bone; it was in the liver,” Demetra explained.

Tanner had stage four medullary thyroid cancer. Doctors tried every treatment available. Nothing worked. They were out of options and Tanner was running out of time.

“It was going to be hospice,” Peter Anderson, MD, an oncologist at Cleveland Clinic Children’s.

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But then, news of a new treatment, approved for use in teenagers and adults, called RETEVMO. It controls cancer with a specific gene mutation.

“If you can flip that switch off then the cancer, which is addicted to this particular mutation, all of a sudden can’t grow,” clarified Dr. Anderson.

Dr. Andersen used RETEVMO on Tanner, who was 17. Within a few treatments, Tanner’s tumors began to shrink.

“My goal was to finish high school and at least get out of high school. And I just kept pushing forward for that,” Tanner shared.

Tanner was a featured speaker at his graduation. More than a year later, cancer no longer dominates every day of the Nobles’ lives.

“This is what you hope for when a child has cancer. We don’t think about those things anymore,” Demetra concluded.

Tanner is now a sophomore at Kent State in Ohio, majoring in psychology. RETEVMO was approved in May for people with non-small cell lung cancer, and two types of thyroid cancer with specific gene mutations, including medullary thyroid cancer. Tanner will need to be on RETEVMO for the rest of his life to keep the cancer at bay.

Contributors to this news report include: Cyndy McGrath, Executive Producer & Field Producer; Kirk Manson, Videographer; Roque Correa, Editor.

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REPORT:  MB #4785

MEDULLARY THYROID CANCER: Thyroid cancer is relatively uncommon compared to other cancers. In 2013, the last year for which statistics are available, over 630,000 patients were living with thyroid cancer in the U.S. Medullary Thyroid Cancer (MTC) accounts for 1% to 2% of thyroid cancers in the United States. It is different from other types of thyroid cancers because it originates from the parafollicular C cells of the thyroid gland. These cells do not make thyroid hormone but instead make a different hormone called calcitonin. MTC frequently spreads to lymph nodes and can also spread to other organs. It is likely to be inherited in 25% of diagnoses, and can be associated with other endocrine tumors, including Multiple Endocrine Neoplasia 2A and MEN 2B. Patients with an inherited form of MTC usually have a mutation in a gene called the RET proto-oncogene. This mutation is present in all the cells in their body and these mutations cause the development of MTC. However, in 75% of patients a germline mutation is not found which indicates that MTC is not an inherited condition. In these cases, MTC is called sporadic.


DIAGNOSIS AND TRADITIONAL TREATMENT: A diagnosis of thyroid cancer is usually made by a fine needle aspiration biopsy of a thyroid nodule, or after the nodule is surgically removed. Patients with the results of an FNA biopsy indicative of MTC should be further evaluated with measurement of the proteins calcitonin and carcinoembryonic antigen in the blood, which are typically elevated in patients with MTC. In inherited forms of medullary thyroid cancer, the growing C cells may form a bump or nodule in a portion of the thyroid gland. Patients may not be diagnosed with this form of cancer unless it has spread to the lymph nodes of the neck and there is a lump in the neck. Patients with sporadic medullary thyroid cancer, may form a bump or nodule in the thyroid that often sticks out of the side or front of the thyroid gland. Therefore, most medullary thyroid cancers are diagnosed after a doctor feels the neck of a patient, by ultrasound or x-ray of the thyroid gland. The primary treatment for medullary thyroid carcinoma is extensive surgical resection. In cases of metastasis, the approach depends on the severity and rate of progression of disease. Metastatic MTC can be treated with limited surgical resection, EBRT, or medical management with tyrosine kinase inhibitors (TKI) or other agents.


NEW TREATMENT: RETEVMO or selpercatinib, a RET specific TKI, received accelerated approval by the FDA in May 2020 for adults and children aged 12 years or older for advanced or metastatic RET MTC and who require systemic therapy. It is the first approval of a therapy for cancer patients with the RET gene alterations. Selpercatinib is a kinase inhibitor which helps prevent cancer cells from growing. Prior to beginning treatment, an RET gene mutation must be determined using laboratory testing. Doctor Peter Anderson, Pediatric Hematologist-Oncologist at the Cleveland Clinic said “This new drug is called RETEVMO or selpercatinib. Before that we had very non-specific treatments that would for example inhibit growth factors for new blood vessels. They were approved for other uses and had a lot of toxicity. So, it was a kind of a hard sell. But once this extremely specific RET inhibitor drug came out, we not only saw responses but with less toxicity too.”





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Doctor Q and A

Read the entire Doctor Q&A for Peter Anderson, MD, Pediatric Hematologist-Oncologist

Read the entire Q&A