Selpercatinib

drug
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Also known as Loxo-292LY-3527723LY3527723Ret inhibitor loxo-292RetevmoRetsevmo

Summary

Selpercatinib (CHEMBL4559134) is an approved small molecule (ATC L01EX22) targeting RET; indicated across 10 conditions including non-small cell lung carcinoma and neoplasm; with CIViC clinical evidence for 31 variant-indication associations (e.g. RET Fusion in lung non-small cell carcinoma).

At a glance

  • Status: Approved (max clinical phase 4)
  • Modality: Small molecule
  • ATC class: L01EX22
  • Targets: 1 (RET)
  • Indications: 10 conditions
  • Clinical trials: 36
  • Precision-oncology evidence (CIViC): 31 variant–indication associations
  • Chemistry: 525.6 Da · C29H31N7O3

Identifiers

Drug identity and classification

FieldValue
ChEMBL IDCHEMBL4559134
NameSelpercatinib
TypeSmall molecule
Max phase4
FDA approvedyes
PubChem CID134436906
ATCL01EX22
Molecular formulaC29H31N7O3
Molecular weight525.6
InChIKeyXIIOFHFUYBLOLW-UHFFFAOYSA-N

SMILES: CC(C)(COC1=CN2C(=C(C=N2)C#N)C(=C1)C3=CN=C(C=C3)N4CC5CC(C4)N5CC6=CN=C(C=C6)OC)O

IUPAC name: 6-(2-hydroxy-2-methylpropoxy)-4-[6-[6-[(6-methoxy-3-pyridinyl)methyl]-3,6-diazabicyclo[3.1.1]heptan-3-yl]-3-pyridinyl]pyrazolo[1,5-a]pyridine-3-carbonitrile

Also known as: Loxo-292, LOXO-292, LY-3527723, LY3527723, Ret inhibitor loxo-292, Retevmo, Retsevmo, Selpercatinib, SELPERCATINIB

Patent coverage: 656 distinct patent families (1,409 SureChEMBL compound mentions), from 3 matched compound structure(s). One matched structure accounts for 1,277 (91%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).

GeneTargetActionpAffinityCancer dependencyUniProt
RETret proto-oncogeneInhibition7.850.4%P07949

Broader ChEMBL bioactivity targets: 2 (assay-derived). Sample: Proto-oncogene tyrosine-protein kinase receptor Ret, Vascular endothelial growth factor receptor 2.

Bioactivity

ChEMBL activities: 31 potent at pChembl ≥ 5 of 31 total. Top 100 by potency (10 = 0.1 nM, 6 = 1 µM):

TargetpChemblTypeValueUnitActivity ID
RET10IC500.1nMCHEMBL_ACT_29235488
RET9.75IC500.18nMCHEMBL_ACT_29146647
RET9.52IC500.3nMCHEMBL_ACT_29235523
RET9.4IC500.4nMCHEMBL_ACT_24867232
RET9.4IC500.4nMCHEMBL_ACT_25016240
RET9.4IC500.4nMCHEMBL_ACT_25935703
RET9.38IC500.42nMCHEMBL_ACT_24867237
RET9.38IC500.42nMCHEMBL_ACT_25016242
RET9.15IC500.7nMCHEMBL_ACT_24867247
RET9.1IC500.8nMCHEMBL_ACT_25016244
RET8.91IC501.24nMCHEMBL_ACT_24419670
RET8.68IC502.1nMCHEMBL_ACT_29235586
RET8.64IC502.3nMCHEMBL_ACT_29119327
RET8.55IC502.8nMCHEMBL_ACT_25061386
RET8.44IC503.6nMCHEMBL_ACT_29235453
RET7.85IC5014nMCHEMBL_ACT_26998390
RET7.85IC5014nMCHEMBL_ACT_27031706
RET7.85IC5014nMCHEMBL_ACT_27874016
RET7.85IC5014nMCHEMBL_ACT_28281512
RET7.82IC5015.1nMCHEMBL_ACT_26998450
RET7.62IC5024.1nMCHEMBL_ACT_27031709
RET7.62IC5024.1nMCHEMBL_ACT_27874019
RET7.62IC5024.1nMCHEMBL_ACT_28281515
RET7.53IC5029.3nMCHEMBL_ACT_26998399
RET7.02IC5095.3nMCHEMBL_ACT_29235588
KDR7IC50100nMCHEMBL_ACT_24867252
RET6.97IC50107.3nMCHEMBL_ACT_29235590
RET6.61IC50244.1nMCHEMBL_ACT_29235558
RET6.28IC50531nMCHEMBL_ACT_27031712
RET6.28IC50531nMCHEMBL_ACT_27874022
RET6.28IC50531nMCHEMBL_ACT_28281518

Target pathways

Aggregated over 1 target gene(s): RET.

Top Reactome pathways

5 total, by targets touching each:

PathwayTargetsGenes
RAF/MAP kinase cascade1RET
RET signaling1RET
NPAS4 regulates expression of target genes1RET
Formation of the nephric duct1RET
Formation of the ureteric bud1RET

Dominant GO biological processes

GO termTargets
MAPK cascade1
ureteric bud development1
neural crest cell migration1
embryonic epithelial tube formation1
homophilic cell-cell adhesion1
neuron cell-cell adhesion1
signal transduction1
cell surface receptor protein tyrosine kinase signaling pathway1
axon guidance1
posterior midgut development1
positive regulation of gene expression1
positive regulation of neuron projection development1
regulation of cell adhesion1
positive regulation of cell migration1
membrane protein proteolysis1

Indications & clinical

Indications

4 approved indications. FDA phase 4, plus an anticancer drug’s labelled cancer uses (which ChEMBL often logs at phase 3).

IndicationPhaseMONDOEFO
non-small cell lung carcinoma4MONDO:0005233EFO:0003060
neoplasm4MONDO:0005070EFO:0000616
thyroid gland papillary carcinoma4MONDO:0005075EFO:0000641
thyroid tumor4MONDO:0015074EFO:0003841

3 diseases in clinical trials (phase 1–3, investigational — not approved indications). Highest ChEMBL trial phase per disease; a non-cancer approved use is occasionally logged at phase 3 here.

Disease (in trials)PhaseMONDOEFO
thyroid gland follicular carcinoma2MONDO:0005034EFO:0000501
liver disorder1MONDO:0005154EFO:0001421
kidney failure1MONDO:0001106HP:0000083

3 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 36.

Phase distribution

PhaseTrials
PHASE115
PHASE211
PHASE33
Not specified3
PHASE1/PHASE22
PHASE41
EARLY_PHASE11

Top trials by phase / activity

NCTPhaseStatusTitle
NCT07010393PHASE4NOT_YET_RECRUITINGGenotype-Driven Neoadjuvant Therapy for Locally Advanced Thyroid Cancer: A Real-World Cohort Study
NCT04194944PHASE3ACTIVE_NOT_RECRUITINGA Study of Selpercatinib (LY3527723) in Participants With Advanced or Metastatic RET Fusion-Positive Non-Small Cell Lung Cancer
NCT04211337PHASE3ACTIVE_NOT_RECRUITINGA Study of Selpercatinib (LY3527723) in Participants With RET-Mutant Medullary Thyroid Cancer
NCT04819100PHASE3ACTIVE_NOT_RECRUITINGA Study of Selpercatinib After Surgery or Radiation in Participants With Non-Small Cell Lung Cancer (NSCLC)
NCT02925234PHASE2RECRUITINGThe Drug Rediscovery Protocol (DRUP Trial)
NCT03155620PHASE2ACTIVE_NOT_RECRUITINGTargeted Therapy Directed by Genetic Testing in Treating Pediatric Patients With Relapsed or Refractory Advanced Solid Tumors, Non-Hodgkin Lymphomas, or Histiocytic Disorders (The Pediatric MATCH Screening Trial)
NCT03157128PHASE1/PHASE2ACTIVE_NOT_RECRUITINGA Study of Selpercatinib (LOXO-292) in Participants With Advanced Solid Tumors, RET Fusion-Positive Solid Tumors, and Medullary Thyroid Cancer (LIBRETTO-001)
NCT03899792PHASE1/PHASE2ACTIVE_NOT_RECRUITINGA Study of Oral LOXO-292 (Selpercatinib) in Pediatric Participants With Advanced Solid or Primary Central Nervous System (CNS) Tumors
NCT03944772PHASE2ACTIVE_NOT_RECRUITINGPhase 2 Platform Study in Patients With Advanced Non-Small Lung Cancer Who Progressed on First-Line Osimertinib Therapy (ORCHARD)
NCT04268550PHASE2ACTIVE_NOT_RECRUITINGTargeted Treatment for RET Fusion-Positive Advanced Non-Small Cell Lung Cancer (A LUNG-MAP Treatment Trial)
NCT04280081PHASE2ACTIVE_NOT_RECRUITINGA Study of Selpercatinib (LY3527723) in Participants With Advanced Solid Tumors Including RET Fusion-positive Solid Tumors, Medullary Thyroid Cancer and Other Tumors With RET Activation
NCT04320888PHASE2ACTIVE_NOT_RECRUITINGSelpercatinib for the Treatment of Advanced Solid Tumors, Lymphomas, or Histiocytic Disorders With Activating RET Gene Alterations, a Pediatric MATCH Treatment Trial
NCT04759911PHASE2ACTIVE_NOT_RECRUITINGSelpercatinib Before Surgery for the Treatment of RET-Altered Thyroid Cancer
NCT05668962PHASE2RECRUITINGRestor. I-131 Upt. + Selpercatinib in RET F-P RAI-R TC
NCT06458036PHASE2RECRUITINGSelpercatinib Pre-RAI in Patients With RET Fusion Thyroid Cancer (RAISE)
NCT04591431PHASE2UNKNOWNThe Rome Trial From Histology to Target: the Road to Personalize Target Therapy and Immunotherapy
NCT05364645PHASE2WITHDRAWNTesting the Use of Targeted Treatment for RET Positive Advanced Non-small Cell Lung Cancer
NCT04782076PHASE1COMPLETEDA Drug Drug Interaction (DDI) Study of Selpercatinib and Dabigatran in Healthy Participants
NCT05089019PHASE1COMPLETEDA Study Comparing Two Formulations of Selpercatinib (LY3527723) in Healthy Participants
NCT05136404PHASE1COMPLETEDA Relative Bioavailability Study of Selpercatinib (LY3527723) in Healthy Participants
NCT05324124PHASE1COMPLETEDA Study of the Effect of Food on Selpercatinib (LY3527723) in Healthy Participants
NCT05338476PHASE1COMPLETEDA Study of Effects of Selpercatinib (LY3527723) on Midazolam in Healthy Participants
NCT05338489PHASE1COMPLETEDA Study of Effects of Itraconazole and Rifampin on Selpercatinib (LY3527723) in Healthy Participants
NCT05338502PHASE1COMPLETEDStudy of H2 Antagonist and a Proton Pump Inhibitor of Selpercatinib in Healthy Participants
NCT05338515PHASE1COMPLETEDA Study of Selpercatinib (LY3527723) in Healthy Participants
NCT05436912PHASE1COMPLETEDA Study of Effects of Selpercatinib in Hepatically Impaired Participants and Healthy Participants
NCT05468164PHASE1COMPLETEDA Study of Effect of Food and a Proton Pump Inhibitor on Selpercatinib (LY3527723) in Healthy Participants
NCT05469100PHASE1COMPLETEDA Study of Effect of Selpercatinib (LY3527723) in Participants With Normal and Impaired Renal Function
NCT05469113PHASE1COMPLETEDA Study of Effects of Selpercatinib (LY3527723) on Repaglinide in Healthy Participants
NCT05630274PHASE1COMPLETEDA Study of Effect of Selpercatinib (LY3527723) on Corrected QT (QTc) Interval in Healthy Participants
NCT05630287PHASE1COMPLETEDA Study of Absorption, Metabolism, Excretion, and Absolute Bioavailability of Carbon-14-Labelled [14C] Selpercatinib (LY3527723) in Healthy Male Participants
NCT05906836PHASE1COMPLETEDA Drug Drug Interaction (DDI) Study of Selpercatinib (LY3527723) and Rosuvastatin in Healthy Participants
NCT07146893EARLY_PHASE1NOT_YET_RECRUITINGFeasibility Study for Repurposing RET Inhibitors
NCT06532149Not specifiedRECRUITINGERectile Dysfunctions, gOnadotoxicity and Sexual Health Assessment in Men With Lung Cancer
NCT03906331Not specifiedAPPROVED_FOR_MARKETINGExpanded Access for the Treatment of Cancers With Rearranged During Transfection (RET) Activation
NCT07543887Not specifiedCOMPLETEDSelpercatinib and Body Composition

Clinical evidence (CIViC)

Variant × indication × effect (31 predictive associations from 40 curated evidence items):

VariantIndicationEffectTherapyLevelCIViC
RET FusionLung Non-small Cell CarcinomaSensitivity/ResponseSelpercatinibCIViC AEID11318 +3
RET MutationMedullary Thyroid CarcinomaSensitivity/ResponseSelpercatinibCIViC AEID12157 +2
RET Fusion OR RET MutationSolid TumorSensitivity/ResponseSelpercatinibCIViC AEID12056 +1
RET FusionThyroid CancerSensitivity/ResponseSelpercatinibCIViC AEID8852
RET M918TMedullary Thyroid CarcinomaSensitivity/ResponseSelpercatinibCIViC AEID12598
RET E632_L633delMedullary Thyroid CarcinomaSensitivity/ResponseSelpercatinibCIViC BEID11875 +2
KIF5B::RET FusionLung CancerSensitivity/ResponseSelpercatinibCIViC BEID7067
RET FusionSolid TumorSensitivity/ResponseSelpercatinibCIViC BEID12134
RET FusionPapillary Thyroid CarcinomaSensitivity/ResponseSelpercatinibCIViC BEID7069
RET V804MMedullary Thyroid CarcinomaSensitivity/ResponseSelpercatinibCIViC CEID6951 +1
KIF5B::RET FusionLung Non-small Cell CarcinomaSensitivity/ResponseSelpercatinibCIViC CEID6948
RET D378_G685>EMedullary Thyroid CarcinomaSensitivity/ResponseSelpercatinibCIViC CEID11658
RET M918T AND RET V804MMedullary Thyroid CarcinomaSensitivity/ResponseSelpercatinibCIViC CEID6950
KIF5B::RET Fusion AND ( RET G810C OR RET G810S OR RET G810R )Lung Non-small Cell CarcinomaResistanceSelpercatinibCIViC CEID8195
KIF5B::RET Fusion AND RET G810SLung Non-small Cell CarcinomaResistanceSelpercatinibCIViC CEID12496
RET G810CCancerResistancePralsetinib + SelpercatinibCIViC CEID8918
RET G810SMedullary Thyroid CarcinomaResistancePralsetinib + SelpercatinibCIViC CEID8919
RET M918T AND RET G810SMedullary Thyroid CarcinomaResistanceSelpercatinibCIViC CEID8196
RET Y806CMedullary Thyroid CarcinomaResistancePralsetinib + SelpercatinibCIViC CEID8920
RET Y806NMedullary Thyroid CarcinomaResistancePralsetinib + SelpercatinibCIViC CEID8921
KIF5B::RET FusionCancerSensitivity/ResponseSelpercatinibCIViC DEID12814
RET C618RCancerSensitivity/ResponseSelpercatinibCIViC DEID11877
RET D898_E901delCancerSensitivity/ResponsePralsetinib + SelpercatinibCIViC DEID11870
RET E632_L633delCancerSensitivity/ResponseSelpercatinibCIViC DEID12712
RET FusionCancerSensitivity/ResponseSelpercatinibCIViC DEID6949
RET M918TCancerSensitivity/ResponsePralsetinib + SelpercatinibCIViC DEID11867
RET M918TCancerSensitivity/ResponseSelpercatinibCIViC DEID11876
RET T930KCancerSensitivity/ResponsePralsetinib + SelpercatinibCIViC DEID11869
RET T930PCancerSensitivity/ResponsePralsetinib + SelpercatinibCIViC DEID11868
RET E632_L633delCancerResistanceSelpercatinib + PralsetinibCIViC DEID12715

+1 more predictive associations (showing top 30 by level).

Pharmacology

Pharmacogenomics

No CPIC/DPWG dosing guideline or drug-level clinical/variant annotations in PharmGKB for this molecule.

Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.

109 molecules share ≥1 primary target. Top 100 by shared-target count:

MoleculeSourceStatusShared targets
AFATINIBChEMBL + PubChemPhase 4 (approved)RET
CRIZOTINIBChEMBL + PubChemPhase 4 (approved)RET
FOSTAMATINIBChEMBL + PubChemPhase 4 (approved)RET
GEFITINIBChEMBL + PubChemPhase 4 (approved)RET
PAZOPANIBChEMBL + PubChemPhase 4 (approved)RET
REGORAFENIBChEMBL + PubChemPhase 4 (approved)RET
ALECTINIBChEMBLPhase 4 (approved)RET
AMITRIPTYLINEChEMBLPhase 4 (approved)RET
AXITINIBChEMBLPhase 4 (approved)RET
BARICITINIBChEMBLPhase 4 (approved)RET
BOSUTINIBChEMBLPhase 4 (approved)RET
BRIGATINIBChEMBLPhase 4 (approved)RET
CABOZANTINIBChEMBLPhase 4 (approved)RET
CAPIVASERTIBChEMBLPhase 4 (approved)RET
CERITINIBChEMBLPhase 4 (approved)RET
CYCLOBENZAPRINEChEMBLPhase 4 (approved)RET
DASATINIBChEMBLPhase 4 (approved)RET
ENTRECTINIBChEMBLPhase 4 (approved)RET
ERLOTINIBChEMBLPhase 4 (approved)RET
FEDRATINIBChEMBLPhase 4 (approved)RET
GILTERITINIBChEMBLPhase 4 (approved)RET
IBRUTINIBChEMBLPhase 4 (approved)RET
INFIGRATINIBChEMBLPhase 4 (approved)RET
LAPATINIBChEMBLPhase 4 (approved)RET
LENVATINIBChEMBLPhase 4 (approved)RET
MIDOSTAURINChEMBLPhase 4 (approved)RET
NILOTINIBChEMBLPhase 4 (approved)RET
NINTEDANIBChEMBLPhase 4 (approved)RET
NORTRIPTYLINEChEMBLPhase 4 (approved)RET
PALBOCICLIBChEMBLPhase 4 (approved)RET
PONATINIBChEMBLPhase 4 (approved)RET
PRALSETINIBChEMBLPhase 4 (approved)RET
QUIZARTINIBChEMBLPhase 4 (approved)RET
RUXOLITINIBChEMBLPhase 4 (approved)RET
SORAFENIBChEMBLPhase 4 (approved)RET
SUNITINIBChEMBLPhase 4 (approved)RET
TIVOZANIBChEMBLPhase 4 (approved)RET
TOFACITINIBChEMBLPhase 4 (approved)RET
UPADACITINIBChEMBLPhase 4 (approved)RET
VANDETANIBChEMBLPhase 4 (approved)RET
VEMURAFENIBChEMBLPhase 4 (approved)RET
ALISERTIBChEMBLPhase 3RET
AMITRIPTYLINOXIDEChEMBLPhase 3RET
BARASERTIBChEMBLPhase 3RET
BRIVANIBChEMBLPhase 3RET
BRIVANIB ALANINATEChEMBLPhase 3RET
CANERTINIBChEMBLPhase 3RET
CEDIRANIBChEMBLPhase 3RET
CRENOLANIBChEMBLPhase 3RET
DEFACTINIBChEMBLPhase 3RET
DOVITINIBChEMBLPhase 3RET
LESTAURTINIBChEMBLPhase 3RET
LINIFANIBChEMBLPhase 3RET
MOTESANIBChEMBLPhase 3RET
ORANTINIBChEMBLPhase 3RET
POZIOTINIBChEMBLPhase 3RET
QUERCETINChEMBLPhase 3RET
RIVOCERANIBChEMBLPhase 3RET
SARACATINIBChEMBLPhase 3RET
SEMAXANIBChEMBLPhase 3RET
TESEVATINIBChEMBLPhase 3RET
VATALANIBChEMBLPhase 3RET
AEE-788ChEMBLPhase 2RET
AT-9283ChEMBLPhase 2RET
AZD-1480ChEMBLPhase 2RET
BAFETINIBChEMBLPhase 2RET
BEMCENTINIBChEMBLPhase 2RET
BFH-772ChEMBLPhase 2RET
BMS-690514ChEMBLPhase 2RET
BMS-754807ChEMBLPhase 2RET
BMS-777607ChEMBLPhase 2RET
CENISERTIBChEMBLPhase 2RET
CEP-11981ChEMBLPhase 2RET
CEP-32496ChEMBLPhase 2RET
CERDULATINIBChEMBLPhase 2RET
DANUSERTIBChEMBLPhase 2RET
DEFOSBARASERTIBChEMBLPhase 2RET
DORAMAPIMODChEMBLPhase 2RET
ENMD-2076ChEMBLPhase 2RET
FGFR INHIBITOR DEBIO 1347ChEMBLPhase 2RET
FORETINIBChEMBLPhase 2RET
GOLVATINIBChEMBLPhase 2RET
ILORASERTIBChEMBLPhase 2RET
LUCITANIBChEMBLPhase 2RET
MERESTINIBChEMBLPhase 2RET
MILCICLIBChEMBLPhase 2RET
MIVAVOTINIBChEMBLPhase 2RET
MK-2461ChEMBLPhase 2RET
NARAZACICLIBChEMBLPhase 2RET
OSI-027ChEMBLPhase 2RET
OSI-632ChEMBLPhase 2RET
PEXMETINIBChEMBLPhase 2RET
R-406ChEMBLPhase 2RET
RAF-265ChEMBLPhase 2RET
REBASTINIBChEMBLPhase 2RET
SAPITINIBChEMBLPhase 2RET
SCH-900776ChEMBLPhase 2RET
SU-014813ChEMBLPhase 2RET
TG100-801ChEMBLPhase 2RET
TOZASERTIBChEMBLPhase 2RET