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1. Which of the following tumor associations would prompt consideration of a RET inhibitor for a patient with medullary thyroid carcinoma?

A. A high degree of BRAF V600 mutations B. A high incidence of RET-activating point mutations C. Epigenetic modifications affecting RET expression D. RET receptor overexpression E. Unsure

2. Which of the following correctly identifies one of the main reasons all patients with advanced non–small-cell lung cancer (NSCLC) or thyroid cancer should undergo genomic testing?

A. Genomic testing can aid in clinical trial enrollment B. Genomic testing can substitute for immunohistochemical testing for RET tumor expression if such assays are not available C. Genomic testing can guide treatment decisions D. Genomic testing can prompt the suggestion of additional treatment options when patients develop acquired resistance E. Unsure

3. RET rearrangements such as gene fusions are found in what percentage of unselected patients with advanced non–small-cell lung cancer (NSCLC)?

A. 1%–2% B. 10%–15% C. 25% D. Unknown; the incidence has not yet been determined E. Unsure

4. You are considering whether RET inhibitor therapy could be effective for your patient who was recently diagnosed with advanced non–small-cell lung cancer (NSCLC). Before beginning such treatment, you should have her tumor biopsy analyzed for RET alterations using which of the following methods?

A. Cytogenetics B. Next-generation sequencing C. A RET-specific diagnostic test approved by the United States Food and Drug Administration (FDA) D. Immunohistochemistry for RET tumor expression E. Unsure

5. The international Global Multicenter RET Registry (GLORY) retrospectively analyzed data from trials in which patients with RET-rearranged non–small-cell lung cancer (NSCLC) were treated with various multikinase inhibitors (MKIs). According to the results, which of the following is correct regarding MKIs in this patient population?

A. These agents have limited efficacy B. MKIs are as effective as RET-specific inhibitors C. Only alectinib and lenvatinib were found to be efficacious D. MKIs are primarily effective in patients with brain metastases E. Unsure

6. Your patient with asymptomatic metastatic medullary thyroid carcinoma is confirmed to have a germline RET mutation. Based on current National Comprehensive Cancer Network (NCCN) guidelines, what is the preferred treatment for this patient?

A. Pralsetinib B. Platinum-based chemotherapy C. Selpercatinib D. Resection followed by best supportive care E. Unsure

7. What is the estimated incidence of brain metastasis at diagnosis among patients with RET-rearranged advanced non–small-cell lung cancer (NSCLC)?

A. >55% B. 25%–30% C. <5% D. 0%; brain metastases do not occur in these patients E. Unsure

8. Which of the following is one of the most common treatment-related class effects seen with RET inhibitors?

A. Weight gain B. Hypertension C. Nail and hair changes D. Increased neutrophil counts E. Unsure

9. A 68-year-old female patient with RET-positive advanced thyroid cancer is prescribed a RET inhibitor, and she asks how you can help her achieve the best outcome. What is one important way a pharmacist can assist this patient?

A. Identify factors that could impact her adherence to treatment B. Coordinate laboratory genomic testing for RET alterations C. Inform her about potential cognitive effects of these agents D. Alert her to discontinue treatment should she develop hypertension E. Unsure

10. Which of the following is TRUE of RET inhibitors compared with cytotoxic chemotherapy and other targeted agents for treatment of RET-altered non–small-cell lung cancer (NSCLC) and thyroid cancer?

A. RET inhibitors result in a longer overall survival B. RET inhibitors have improved pharmacokinetics C. RET inhibitors result in better synergy when combined with immune checkpoint inhibitors D. RET inhibitors have greater selectivity E. Unsure

Evaluation Questions

11. How confident are you in the assistance selected for the 68 year old patient in question 9?

A. Not at all confident B. Somewhat confident C. Confident D. Highly confident

Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. Which of the following tumor associations would prompt consideration of a RET inhibitor for a patient with medullary thyroid carcinoma?

2. Which of the following correctly identifies one of the main reasons all patients with advanced non–small-cell lung cancer (NSCLC) or thyroid cancer should undergo genomic testing?

3. RET rearrangements such as gene fusions are found in what percentage of unselected patients with advanced non–small-cell lung cancer (NSCLC)?

4. You are considering whether RET inhibitor therapy could be effective for your patient who was recently diagnosed with advanced non–small-cell lung cancer (NSCLC). Before beginning such treatment, you should have her tumor biopsy analyzed for RET alterations using which of the following methods?

6. Your patient with asymptomatic metastatic medullary thyroid carcinoma is confirmed to have a germline RET mutation. Based on current National Comprehensive Cancer Network (NCCN) guidelines, what is the preferred treatment for this patient?

7. What is the estimated incidence of brain metastasis at diagnosis among patients with RET-rearranged advanced non–small-cell lung cancer (NSCLC)?

8. Which of the following is one of the most common treatment-related class effects seen with RET inhibitors?

9. A 68-year-old female patient with RET-positive advanced thyroid cancer is prescribed a RET inhibitor, and she asks how you can help her achieve the best outcome. What is one important way a pharmacist can assist this patient?

10. Which of the following is TRUE of RET inhibitors compared with cytotoxic chemotherapy and other targeted agents for treatment of RET-altered non–small-cell lung cancer (NSCLC) and thyroid cancer?

Evaluation Questions

11. How confident are you in the assistance selected for the 68 year old patient in question 9?

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Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. Which of the following tumor associations would prompt consideration of a RET inhibitor for a patient with medullary thyroid carcinoma?

2. Which of the following correctly identifies one of the main reasons all patients with advanced non–small-cell lung cancer (NSCLC) or thyroid cancer should undergo genomic testing?

3. RET rearrangements such as gene fusions are found in what percentage of unselected patients with advanced non–small-cell lung cancer (NSCLC)?

6. Your patient with asymptomatic metastatic medullary thyroid carcinoma is confirmed to have a germline RET mutation. Based on current National Comprehensive Cancer Network (NCCN) guidelines, what is the preferred treatment for this patient?

7. What is the estimated incidence of brain metastasis at diagnosis among patients with RET-rearranged advanced non–small-cell lung cancer (NSCLC)?

8. Which of the following is one of the most common treatment-related class effects seen with RET inhibitors?

9. A 68-year-old female patient with RET-positive advanced thyroid cancer is prescribed a RET inhibitor, and she asks how you can help her achieve the best outcome. What is one important way a pharmacist can assist this patient?

10. Which of the following is TRUE of RET inhibitors compared with cytotoxic chemotherapy and other targeted agents for treatment of RET-altered non–small-cell lung cancer (NSCLC) and thyroid cancer?

Evaluation Questions

11. How confident are you in the assistance selected for the 68 year old patient in question 9?

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