1. Indications:

Selpacta (Selpercatinib) 40 mg is indicated for the treatment of:

• Metastatic RET fusion-positive non-small cell lung cancer (NSCLC) in adults.
• Advanced or metastatic RET-mutant medullary thyroid cancer (MTC) in adults and pediatric patients aged 12 years and older who require systemic therapy.
• Advanced or metastatic RET fusion-positive thyroid cancer in adults and pediatric patients aged 12 years and older who require systemic therapy and who are radioactive iodine-refractory (if radioactive iodine is appropriate).

2. Pharmacology:

Selpacta (Selpercatinib) 40 mg exerts its pharmacological effects by selectively inhibiting the activity of rearranged during transfection (RET) tyrosine kinase receptors, which are involved in cancer cell proliferation and survival. By targeting aberrant RET signaling pathways, Selpacta inhibits tumor growth and metastasis, particularly in cancers harboring RET gene alterations.

3. Dosage and Administration:

The recommended dosage of Selpacta (Selpercatinib) 40 mg may vary depending on the type of cancer being treated, patient characteristics, and individual tumor molecular profile. Typically, the prescribed dose is 120 mg taken orally twice daily, with or without food. Treatment should continue until disease progression, unacceptable toxicity, or other treatment discontinuation criteria are met. Dose adjustments or discontinuation may be necessary based on individual patient response and tolerability.

4. Interaction:

Selpacta (Selpercatinib) 40 mg may interact with other medications, including:

• Strong CYP3A inhibitors or inducers: Co-administration with drugs that affect CYP3A metabolism may alter the plasma concentration of Selpercatinib.
• Acid-reducing agents: Concurrent use of proton pump inhibitors (PPIs) or H2-receptor antagonists may decrease the absorption of Selpercatinib, potentially reducing its efficacy.

Patients should inform their healthcare provider about all medications they are taking, including prescription, over-the-counter, and herbal products, to avoid potential interactions.

5. Side Effects:

Common side effects associated with Selpacta (Selpercatinib) 40 mg may include:

• Hypertension (high blood pressure)
• Fatigue
• Diarrhea
• Constipation
• Elevated liver enzymes
• Decreased appetite

Patients should report any persistent or severe side effects to their healthcare provider for further evaluation and management.

6. Precautions and Warnings:

Before using Selpacta (Selpercatinib) 40 mg, patients should be aware of the following precautions:

• Selpercatinib may cause hypertension, which should be monitored and managed appropriately during treatment.
• Hepatotoxicity, including liver function abnormalities, has been reported with Selpercatinib. Liver function tests should be performed before starting treatment and periodically thereafter.
• Selpercatinib may cause fetal harm if used during pregnancy. Female patients of reproductive potential should use effective contraception during treatment and for at least one week after the last dose.

7. Overdose Effects:

In case of overdose with Selpacta (Selpercatinib) 40 mg, supportive care should be initiated, and symptomatic treatment may be administered as necessary. There is no specific antidote for Selpercatinib overdose, and patients should seek immediate medical attention if overdose is suspected.