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Peer-reviewedCC BY 4.0Acta Oncologica

RET fusion–positive non-small cell lung cancer in Sweden: a nationwide registry study

  • Ella Äng Eklund1,2
  • Hans Brunnström3
  • Erik Lampa4
  • Kerstin Gunnarsson1,5
  • Anders Vikström6
  • Johan Isaksson7
  • Kristina Lamberg8
  • Johan Botling2,9
  • Henrik Fagman2,9
  • Sama I. Sayin10,11
  • Gunnar Wagenius12
  • Levent M. Akyurek2,9
3 more authors
  • Anders Berglund4
  • Volkan I. Sayin10,11
  • Andreas Hallqvist1,5
12 affiliations
  1. 1Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
  2. 2Department of Laboratory Medicine, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
  3. 3Department of Genetics, Pathology, and Molecular Diagnostics, Skåne University Hospital, Lund, Sweden
  4. 4Epistat AB, Uppsala, Sweden
  5. 5Department of Oncology, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
  6. 6Department of Respiratory Medicine, Linköping University Hospital, Linköping, Sweden
  7. 7Centre of Research and Development Region Gävleborg, Uppsala University, Sweden
  8. 8Department of Medical Sciences, Section of Pulmonology, Uppsala University Hospital, Uppsala, Sweden
  9. 9Department of Clinical Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
  10. 10Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Center for Cancer Research, University of Gothenburg, Gothenburg, Sweden
  11. 11Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
  12. 12Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
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Abstract

Background: Rearranged during transfection (RET) fusion–positive non-small cell lung cancer (NSCLC) is a rare but clinically meaningful molecular subgroup. RET inhibitors have demonstrated marked clinical activity; however, real-world data on disease characteristics and outcomes before their widespread introduction remain limited. This study characterizes clinical features, treatment patterns, and survival outcomes of RET fusion–positive NSCLC in a nationwide Swedish cohort, with other driver subgroups as descriptive comparisons.

Methods: Patients ≥18 years diagnosed with histologically confirmed NSCLC in 2018–2022, registered in the Swedish National Lung Cancer Registry and with next-generation sequencing results available, were included. Individuals were categorized by oncogenic driver status, including RET, ALK, BRAF, EGFR, KRAS, ROS1, or wild type. Progression-free survival (PFS) and overall survival (OS) from diagnosis were estimated using Kaplan–Meier methods and standardized Cox proportional hazards models adjusted for age, sex, performance status, smoking, stage, and histology.

Results: A total of 68 patients had RET fusion–positive NSCLC. The RET cohort was characterized by younger age, a high proportion of never-smokers (59%), and predominantly adenocarcinoma histology (96%). Most had stage IV disease at diagnosis and the highest rate of liver metastases (56%). KIF5B–RET (71%) and CCDC6–RET (19%) were the most frequent fusion partners. Adjusted median OS was 28 months (95% confidence interval [CI]: 13–46) for RET, 39 months (95% CI: 29–52) for ALK, and 17–26 months for the other groups, with overlapping CIs.

Conclusion: RET fusion–positive patients were typically younger never-smokers with adenocarcinoma and had encouraging OS, despite limited access to selective RET inhibitors during the study period.

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Cite

BibTeXRIS
BibTeX
@article{eklund2026fusionpositive,
  title = {{RET fusion–positive non-small cell lung cancer in Sweden: a nationwide registry study}},
  author = {Ella Äng Eklund and Hans Brunnström and Erik Lampa and Kerstin Gunnarsson and Anders Vikström and Johan Isaksson and Kristina Lamberg and Johan Botling and Henrik Fagman and Sama I. Sayin and Gunnar Wagenius and Levent M. Akyurek and Anders Berglund and Volkan I. Sayin and Andreas Hallqvist},
  journal = {Acta Oncologica},
  year = {2026},
  month = oct,
  doi = {10.2340/1651-226x.2026.46817},
  url = {https://doi.org/10.2340/1651-226x.2026.46817},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - RET fusion–positive non-small cell lung cancer in Sweden: a nationwide registry study
AU  - Ella Äng Eklund
AU  - Hans Brunnström
AU  - Erik Lampa
AU  - Kerstin Gunnarsson
AU  - Anders Vikström
AU  - Johan Isaksson
AU  - Kristina Lamberg
AU  - Johan Botling
AU  - Henrik Fagman
AU  - Sama I. Sayin
AU  - Gunnar Wagenius
AU  - Levent M. Akyurek
AU  - Anders Berglund
AU  - Volkan I. Sayin
AU  - Andreas Hallqvist
PY  - 2026
DA  - 2026/10/29
JO  - Acta Oncologica
DO  - 10.2340/1651-226x.2026.46817
UR  - https://doi.org/10.2340/1651-226x.2026.46817
AB  - Background: Rearranged during transfection (RET) fusion–positive non-small cell lung cancer (NSCLC) is a rare but clinically meaningful molecular subgroup. RET inhibitors have demonstrated marked clinical activity; however, real-world data on disease characteristics and outcomes before their widespread introduction remain limited. This study characterizes clinical features, treatment patterns, and survival outcomes of RET fusion–positive NSCLC in a nationwide Swedish cohort, with other driver subgroups as descriptive comparisons.  Methods: Patients ≥18 years diagnosed with histologically confirmed NSCLC in 2018–2022, registered in the Swedish National Lung Cancer Registry and with next-generation sequencing results available, were included. Individuals were categorized by oncogenic driver status, including RET, ALK, BRAF, EGFR, KRAS, ROS1, or wild type. Progression-free survival (PFS) and overall survival (OS) from diagnosis were estimated using Kaplan–Meier methods and standardized Cox proportional hazards models adjusted for age, sex, performance status, smoking, stage, and histology.  Results: A total of 68 patients had RET fusion–positive NSCLC. The RET cohort was characterized by younger age, a high proportion of never-smokers (59%), and predominantly adenocarcinoma histology (96%). Most had stage IV disease at diagnosis and the highest rate of liver metastases (56%). KIF5B–RET (71%) and CCDC6–RET (19%) were the most frequent fusion partners. Adjusted median OS was 28 months (95% confidence interval [CI]: 13–46) for RET, 39 months (95% CI: 29–52) for ALK, and 17–26 months for the other groups, with overlapping CIs.  Conclusion: RET fusion–positive patients were typically younger never-smokers with adenocarcinoma and had encouraging OS, despite limited access to selective RET inhibitors during the study period.
SN  - 0284-186X
SN  - 1651-226X
ER  -