Lilly's Retevmo (selpercatinib) delivers substantial event-free survival benefit as an adjuvant therapy in early-stage RET fusion-positive lung cancer
Rhea-AI Summary
Lilly (NYSE:LLY) reported positive topline results from the Phase 3 LIBRETTO-432 trial: adjuvant Retevmo (selpercatinib) met the primary endpoint with a highly statistically significant and clinically meaningful improvement in investigator-assessed event-free survival (EFS) in early-stage (II-IIIA) RET fusion-positive NSCLC.
Overall survival trended favorably but was immature at analysis; safety was generally consistent with prior selpercatinib trials. Detailed data will be presented at a medical congress and submitted for peer review.
Positive
- Primary endpoint met: significant EFS improvement
- Safety profile consistent with prior selpercatinib trials
- First randomized Phase 3 adjuvant RET kinase inhibitor study
Negative
- Overall survival data immature at time of analysis
Key Figures
Market Reality Check
Peers on Argus
LLY was up 0.17% while large-cap peers showed mixed moves: ABBV +1.35%, NVS +0.58%, NVO +0.55%, JNJ -0.47%, AZN -0.04%, pointing to stock-specific drivers.
Historical Context
| Date | Event | Sentiment | Move | Catalyst |
|---|---|---|---|---|
| Feb 09 | Acquisition announcement | Positive | -1.3% | Orna Therapeutics acquisition to expand in vivo cell therapy platform. |
| Feb 04 | Earnings and guidance | Positive | +10.3% | Q4 2025 beat with strong 2026 revenue and EPS guidance outlook. |
| Jan 30 | Manufacturing investment | Positive | +1.3% | Over $3.5B Pennsylvania facility to support next-gen weight-loss drugs. |
| Jan 21 | Earnings call notice | Neutral | +3.6% | Announcement of timing for Q4 2025 results and investor call. |
| Jan 20 | Oncology designation | Positive | +0.3% | FDA Breakthrough Therapy designation for ovarian cancer candidate. |
LLY often reacted positively to strong fundamentals and oncology milestones, with a single negative reaction around an acquisition announcement.
Over the last month, LLY reported strong Q4 2025 results with revenue of $19.3B and 2026 guidance of $80–$83B, which coincided with a 10.33% gain. The company also announced a more than $3.5 billion manufacturing investment and received FDA Breakthrough Therapy designation for sofetabart mipitecan, both followed by modest gains. An acquisition of Orna Therapeutics saw a -1.28% reaction, showing not all strategic deals draw positive responses. Today’s adjuvant NSCLC data adds to this oncology-focused momentum.
Market Pulse Summary
This announcement highlights meaningful Phase 3 LIBRETTO-432 results for selpercatinib as adjuvant therapy in early-stage RET fusion-positive NSCLC, with a clear event-free survival benefit and safety consistent with earlier studies. It extends Lilly’s recent oncology momentum alongside the FDA Breakthrough Therapy designation for sofetabart mipitecan and comes on top of strong Q4 2025 results with $19.3B revenue. Investors may watch for detailed data at upcoming conferences, regulatory interactions, and how this fits within Lilly’s broader oncology and biomarker-driven strategy.
Key Terms
event-free survival medical
adjuvant therapy medical
Phase 3 medical
non-small cell lung cancer medical
RET fusion-positive medical
genomic testing medical
biomarkers medical
AI-generated analysis. Not financial advice.
Selpercatinib demonstrated a highly statistically significant and clinically meaningful improvement in reducing the risk of disease recurrence or death
Results from the LIBRETTO-432 trial build on previous results for selpercatinib in advanced NSCLC and reinforce the value of genomic testing at diagnosis and across all stages of disease
Overall survival results trended in favor of selpercatinib, but were immature at the time of this analysis with few events observed. The overall safety profile of selpercatinib in LIBRETTO-432 was generally consistent with previously reported trials in the selpercatinib development program.
Detailed results will be presented at an upcoming medical congress, submitted to a peer-reviewed journal, and discussed with health authorities globally.
"We have consistently observed that cancer medicines can deliver their greatest impact when administered early in the course of a patient's treatment journey. The LIBRETTO-432 results support this observation, demonstrating an effect size in line with the most striking data for targeted adjuvant therapy in lung cancer," said Jacob Van Naarden, executive vice president and president of Lilly Oncology. "Building on the adoption of targeted therapies for early-stage patients with EGFR- and ALK-driven lung cancer, we hope these results further accelerate the use of genomic testing for all people diagnosed with early-stage disease."
LIBRETTO-432 is the first and only randomized Phase 3 study to evaluate the safety and efficacy of a selective RET kinase inhibitor as adjuvant therapy in this population.
NSCLC accounts for about 85 percent of all lung cancer diagnoses in the
For more information on the LIBRETTO Phase 3 clinical trial program, please visit clinicaltrials.gov.
About LIBRETTO-432
LIBRETTO-432 is a Phase 3, global, multicenter, randomized, double-blind, controlled clinical trial of selpercatinib versus placebo in patients with RET fusion-positive NSCLC following completion of definitive radiotherapy or surgery with curative intent, and other adjuvant therapy, if indicated. The trial enrolled 151 patients who were randomized 1:1 to receive either selpercatinib or placebo as adjuvant therapy for RET fusion-positive NSCLC. The primary endpoint is EFS as assessed by investigator in the primary analysis population, which was comprised of patients with stage II-IIIA RET fusion-positive NSCLC. Secondary endpoints include EFS as assessed by investigator in the overall population, overall survival (OS), EFS as assessed by blinded independent central review (BICR), time to distant disease recurrence in the central nervous system (CNS) as assessed by investigator and BICR, progression-free survival on the next line of treatment (PFS2), positive predictive value (PPV) of RET tests from investigator-identified laboratories with respect to the Lilly-designated RET test, safety and tolerability.
About Retevmo
Retevmo (selpercatinib, formerly known as LOXO-292) (pronounced reh-TEHV-moh) is a highly selective and potent RET kinase inhibitor with central nervous system (CNS) activity. Retevmo may affect both tumor cells and healthy cells, which can result in side effects. RET-driver alterations are predominantly mutually exclusive from other oncogenic drivers. Retevmo is a
INDICATIONS FOR RETEVMO (selpercatinib)
RETEVMO is a kinase inhibitor indicated for the treatment of:
- Adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with a rearranged during transfection (RET) gene fusion, as detected by an FDA-approved test
IMPORTANT SAFETY INFORMATION FOR RETEVMO (selpercatinib)
Hepatotoxicity: Serious hepatic adverse reactions occurred in
Severe, life-threatening, and fatal interstitial lung disease (ILD)/pneumonitis can occur in patients treated with Retevmo. ILD/pneumonitis occurred in
Hypertension occurred in
Retevmo can cause concentration-dependent QT interval prolongation. An increase in QTcF interval to >500 ms was measured in
Serious, including fatal, hemorrhagic events can occur with Retevmo. Grade ≥3 hemorrhagic events occurred in
Retevmo can cause hypersensitivity, including severe skin reactions such as Stevens-Johnson Syndrome. All grade hypersensitivity occurred in
Tumor lysis syndrome (TLS) occurred in
Impaired wound healing can occur in patients who receive drugs that inhibit the vascular endothelial growth factor (VEGF) signaling pathway. Therefore, Retevmo has the potential to adversely affect wound healing. Withhold Retevmo for at least 7 days prior to elective surgery. Do not administer for at least 2 weeks following major surgery and until adequate wound healing. The safety of resumption of Retevmo after resolution of wound healing complications has not been established.
Retevmo can cause hypothyroidism. Hypothyroidism occurred in
Based on data from animal reproduction studies and its mechanism of action, Retevmo can cause fetal harm when administered to a pregnant woman. Administration of selpercatinib to pregnant rats during organogenesis at maternal exposures that were approximately equal to those observed at the recommended human dose of 160 mg twice daily resulted in embryolethality and malformations. Advise pregnant women and females of reproductive potential of the potential risk to a fetus. Advise females of reproductive potential and males with female partners of reproductive potential to use effective contraception during treatment with Retevmo and for 1 week after the last dose. There are no data on the presence of selpercatinib or its metabolites in human milk or on their effects on the breastfed child or on milk production. Because of the potential for serious adverse reactions in breastfed children, advise women not to breastfeed during treatment with Retevmo and for 1 week after the last dose.
Severe adverse reactions (Grade 3-4) occurring in ≥
Severe adverse reactions (Grade 3-4) occurring in ≥
Serious adverse reactions occurred in
Serious adverse reactions occurred in
Common adverse reactions (all grades) occurring in ≥
Common adverse reactions (all grades) occurring in ≥
Laboratory abnormalities (all grades ≥
Laboratory abnormalities (all grades ≥
Concomitant use of acid-reducing agents decreases selpercatinib plasma concentrations which may reduce Retevmo anti-tumor activity. Avoid concomitant use of proton-pump inhibitors (PPIs), histamine-2 (H2) receptor antagonists, and locally acting antacids with Retevmo. If coadministration cannot be avoided, take Retevmo with food (with a PPI) or modify its administration time (with a H2 receptor antagonist or a locally acting antacid).
Concomitant use of strong and moderate CYP3A inhibitors increases selpercatinib plasma concentrations which may increase the risk of Retevmo adverse reactions including QTc interval prolongation. Avoid concomitant use of strong and moderate CYP3A inhibitors with Retevmo. If concomitant use of a strong or moderate CYP3A inhibitor cannot be avoided, reduce the Retevmo dosage as recommended and monitor the QT interval with ECGs more frequently.
Concomitant use of strong and moderate CYP3A inducers decreases selpercatinib plasma concentrations which may reduce Retevmo anti-tumor activity. Avoid coadministration of Retevmo with strong and moderate CYP3A inducers.
Concomitant use of Retevmo with CYP2C8 and CYP3A substrates increases their plasma concentrations which may increase the risk of adverse reactions related to these substrates. Avoid coadministration of Retevmo with CYP2C8 and CYP3A substrates where minimal concentration changes may lead to increased adverse reactions. If coadministration cannot be avoided, follow recommendations for CYP2C8 and CYP3A substrates provided in their approved product labeling.
Retevmo is a P-glycoprotein (P-gp) and BCRP inhibitor. Concomitant use of Retevmo with P-gp or BCRP substrates increases their plasma concentrations, which may increase the risk of adverse reactions related to these substrates. Avoid coadministration of Retevmo with P-gp or BCRP substrates where minimal concentration changes may lead to increased adverse reactions. If coadministration cannot be avoided, follow recommendations for P-gp and BCRP substrates provided in their approved product labeling.
No dosage modification is recommended for patients with mild to severe renal impairment (estimated Glomerular Filtration Rate [eGFR] ≥15 to 89 mL/min, estimated by Modification of Diet in Renal Disease [MDRD] equation). A recommended dosage has not been established for patients with end-stage renal disease.
Reduce the dose when administering Retevmo to patients with severe hepatic impairment (total bilirubin greater than 3 to 10 times upper limit of normal [ULN] and any AST). No dosage modification is recommended for patients with mild or moderate hepatic impairment. Monitor for Retevmo-related adverse reactions in patients with hepatic impairment.
Retevmo (selpercatinib) is available as 40 mg and 80 mg capsules, and 40 mg, 80 mg, 120 mg, and 160 mg tablets.
SE HCP ISI LA_NOV2025
Please see full Prescribing Information, including Instructions for Use, for Retevmo.
About Lilly
Lilly is a medicine company turning science into healing to make life better for people around the world. We've been pioneering life-changing discoveries for nearly 150 years, and today our medicines help tens of millions of people across the globe. Harnessing the power of biotechnology, chemistry and genetic medicine, our scientists are urgently advancing new discoveries to solve some of the world's most significant health challenges: redefining diabetes care; treating obesity and curtailing its most devastating long-term effects; advancing the fight against Alzheimer's disease; providing solutions to some of the most debilitating immune system disorders; and transforming the most difficult-to-treat cancers into manageable diseases. With each step toward a healthier world, we're motivated by one thing: making life better for millions more people. That includes delivering innovative clinical trials that reflect the diversity of our world and working to ensure our medicines are accessible and affordable. To learn more, visit Lilly.com and Lilly.com/news, or follow us on Facebook, Instagram, and LinkedIn. P-LLY
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Trademarks and Trade Names
All trademarks or trade names referred to in this press release are the property of the company, or, to the extent trademarks or trade names belonging to other companies are references in this press release, the property of their respective owners. Solely for convenience, the trademarks and trade names in this press release are referred to without the ® and ™ symbols, but such references should not be construed as any indicator that the company or, to the extent applicable, their respective owners will not assert, to the fullest extent under applicable law, the company's or their rights thereto. We do not intend the use or display of other companies' trademarks and trade names to imply a relationship with, or endorsement or sponsorship of us by, any other companies.
Cautionary Statement Regarding Forward-Looking Statements
This press release contains forward-looking statements (as that term is defined in the Private Securities Litigation Reform Act of 1995) about Retevmo as a potential treatment for rearranged during transfection (RET) fusion-positive stage IB-IIIA NSCLC following completion of definitive radiotherapy or surgery with curative intent, and other adjuvant therapy if indicated, and reflects Lilly's current beliefs and expectations. However, as with any pharmaceutical product, there are substantial risks and uncertainties in the process of drug research, development, and commercialization. Among other things, there is no guarantee that planned or ongoing studies will be completed as planned, that future study results will be consistent with study results to date, or that Retevmo will receive additional regulatory approvals. For further discussion of these and other risks and uncertainties that could cause actual results to differ from Lilly's expectations, see Lilly's Form 10-K and Form 10-Q filings with the United States Securities and Exchange Commission. Except as required by law, Lilly undertakes no duty to update forward-looking statements to reflect events after the date of this release.
Endnotes & References
- American Cancer Society. What is Lung Cancer? January 2024. https://www.cancer.org/cancer/types/lung-cancer/about/what-is.html
- Goldman, JW, Sands, J, Hallqvist, A, et al. LIBRETTO-432: A phase 3 study of adjuvant selpercatinib or placebo in stage IB-IIIA RET fusion-positive (RET+) NSCLC. J Clinc Oncol 2024;42:16. Published 2024 May 29. doi:10.1200/JCO.2024.42.16_suppl.TPS811
- Huang RSP, et al. Landscape of Biomarkers in Non-small Cell Lung Cancer Using Comprehensive Genomic Profiling and PD-L1 Immunohistochemistry. Pathol Oncol Res. 2021;27:592997. Published 2021 Mar 11. doi:10.3389/pore.2021.592997
- Wang R, Hu H, Pan Y, et al. RET fusions define a unique molecular and clinicopathologic subtype of non-small-cell lung cancer. J Clin Oncol 2012;30:4352-4359.
- Retevmo. Prescribing information. Lilly USA, LLC.
Refer to: Kyle Owens; owens_kyle@lilly.com; (332) 259-3932 (Media)
Michael Czapar; czapar_michael_c@lilly.com; (317) 617-0983 (Investors)
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SOURCE Eli Lilly and Company
