Can you stop taking Seputinib/Serpatinib (Ruitu) once you take it?

For patients who are receiving Selpercatinib/Selpercatinib treatment, "Can the drug be discontinued?" is one of the most frequently asked questions in clinical practice. Seputinib is an oral RET kinase inhibitor that fundamentally inhibits tumor cell growth and division by blocking the signaling pathway activated by RET fusion or mutation. Its mechanism of action determines that it is a "sustained target inhibitory" drug, that is, the maintenance of drug efficacy depends on the continued concentration of the drug in the body.

In most cases, seputinib is not a drug that can be taken for a short period of time and then completely discontinued. For chronic tumor diseases such as RET fusion-positive non-small cell lung cancer (NSCLC) or RET-mutant medullary thyroid cancer, the treatment goal is usually to control the progression of the disease rather than completely eliminate the cancer cells. When patients take medication for a long time, the drug's continued inhibition of the RET pathway can keep the disease stable. Once the drug is stopped suddenly and the inhibitory signal is interrupted, the tumor cells may become active again and the disease may rebound or progress. Multiple overseas follow-up studies have shown that some patients have short-term tumor enlargement on imaging after discontinuing seputinib, suggesting the risk of "rebound growth" after discontinuation of treatment.

Of course, it is not possible to discontinue seputinib forever. In the following situations, doctors may recommend adjusting or interrupting treatment: first, serious adverse reactions occur, such as significant liver function damage, sustained hypertension, or prolongation of the QT interval; second, imaging or clinical evaluation shows disease progression, indicating the occurrence of drug resistance; third, the patient has special circumstances such as medication conflicts or surgery. Discontinuation or reduction of medication at this time is for safety reasons rather than permanent suspension. Doctors will usually decide whether to resume medication or switch to other targeted regimens after evaluation.

It should be emphasized that the decision to discontinue seputinib should always be made by a clinical oncologist based on the comprehensive judgment of the patient's condition. Unauthorized discontinuation of medication may lead to rapid disease progression and even affect subsequent treatment response.

Reference:https://en.wikipedia.org/wiki/Selpercatinib