What to do after platinib resistance? Can I still change the medicine?

Pralsetinib (Pralsetinib) performs well in RET fusion lung cancer, but some patients may develop resistance after taking the drug for a period of time. The reason for drug resistance may be related to mechanisms such as secondary mutations of the RET gene and activation of bypass pathways, which cause tumor cells to lose sensitivity to platinib. For drug-resistant patients, genetic testing is first needed to determine the drug-resistant mechanism. If it is a secondary mutation of RET, there is still a lack of more potent RET inhibitors in clinical practice, but combination therapy, such as combination chemotherapy or immunotherapy, can be considered. If it is a bypass activation mechanism, doctors may recommend other targeted drugs, such as inhibitors targeting pathways such as MET or EGFR.