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Selpercatinib

Phase 3

Medullary Thyroid Cancer | Small molecule | Oncology |Eli Lilly and Company|Last Updated: Mar 19, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedCONTROLLEDDMCBiomarker
Total Trials2
Total Enrollment327
FDA Designations
No designations recorded
Clinical Trials (2)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT04211337A Study of Selpercatinib (LY3527723) in Participants With RET-Mutant Medullary Thyroid CancerPHASE3 ACTIVE NOT_RECRUITING 291Feb 11, 2020Nov 1, 2027Mar 19, 2026143 United States, Australia +18
NCT03899792A Study of Oral LOXO-292 (Selpercatinib) in Pediatric Participants With Advanced Solid or Primary Central Nervous System (CNS) TumorsPHASE1 ACTIVE NOT_RECRUITING 36Jun 13, 2019May 1, 2029Jan 6, 202626 United States, Australia +9
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Study Endpoints
Primary Endpoints
Progression Free Survival (PFS) by Blinded Independent Central Review (BICR)
Baseline to Progressive Disease or Death from Any Cause, Whichever Occurs First, Up to 39 Months

PFS is defined as the time from randomization until the occurrence of documented disease progression by the BICR, per Response Evaluation Criteria in Solid Tumors (RECIST 1.1) criteria, or death from any cause in the absence of BICR-documented progressive disease. Progressive Disease (PD) was at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions.

Phase 1: Number of Participants With Dose Limiting Toxicities (DLTs)
Cycle 1 (28 Day Cycle)

A DLT was any of the adverse events that starts on or after the first administration of study drug listed below, as defined by the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE) v5.0. * Any Grade(G) ≥3 nonhematologic toxicity except G3 fatigue, nausea, tendon reflex decrease, weight gain attributable to normal growth and development. * G3 vomiting/diarrhea was DLT only if it persists \>48 h despite standard of care treatment. * G4 vomiting/diarrhea was DLT regardless of duration. * Any toxicity, regardless of the NCI CTCAE v5.0 grade, resulting in discontinuation or dose reduction of treatment (except symptoms related to progressive disease (PD)). * G4/G3 thrombocytopenia with G1 or higher bleeding. * G4 anemia lasting \>8 days, despite supportive therapy. * G4 neutropenia, lasting \>8 days, despite supportive therapy

Phase 2: Percentage of Participants With Overall Response Rate (ORR) in Study
Date of first dose to disease progression or death (Up to 62.4 Months)

ORR: Percentage of participants who achieve best overall response Complete Response (CR) or Partial Response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST). * CR is defined as disappearance of all target lesions. * PR is defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.

Secondary Endpoints
Treatment Failure-Free Survival (TFFS) by Blinded Independent Committee Review (BICR)
Baseline to Progressive Disease, Unacceptable Toxicity or Death from Any Cause Up to 39 Months
Overall Response Rate (ORR): Percentage of Participants With Complete Response (CR) or Partial Response (PR) by BICR
Baseline through Disease Progression or Death Up to 39 Months
Duration of Response (DoR) by BICR
Date of CR or PR to Date of Disease Progression or Death Due to Any Cause Up to 39 Months
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Study Design & Arms
AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Selpercatinib - Treatment A (TRT A)EXPERIMENTAL160 milligrams Selpercatinib administered orally (PO) twice daily (BID). Adolescent Dose: 92 milligrams per square meter (mg/m2) BID (not to exceed 160 mg BID).
Cabozantinib or Vandetanib - Treatment B (TRT B)ACTIVE_COMPARATOR140 mg Cabozantinib administered orally daily (QD) or 300 mg Vandetanib administered orally QD per physician choice. Cabozantinib Adolescent Dose: 40 mg/m2. Vandetanib Adolescent Dose: * 0.7 - \<0.9 - 100 mg every other day (QOD) * 0.9 - \<1.2 - 100 mg QD * 1.2 - \<1.6 - 7-day schedule 100 mg - 200 mg - 100 mg - 200 mg - 100 mg - 200 mg - 100 mg * ≥1.6 - 200 QD
Cohort 1: Medullary Thyroid Cancer (MTC) GroupEXPERIMENTALParticipants in this cohort had MTC and received 160 mg of selpercatinib BID orally on Days 1 through 28 of a 28-day cycle. The treatment was continued until participants experienced a progressive disease, unacceptable toxicity, or other protocol-defined reason for discontinuation.
Cohort 2: Papillary Thyroid Cancer (PTC) GroupEXPERIMENTALParticipants in this cohort had PTC and received 160 mg of selpercatinib BID orally on Days 1 through 28 of a 28-day cycle. The treatment was continued until participants experienced a progressive disease, unacceptable toxicity, or other protocol-defined reason for discontinuation.
Cohort 3: Other Cancer GroupEXPERIMENTALParticipants in this cohort had other (REarranged during Transfection (RET)-altered non-thyroid) cancer and received 160 mg of selpercatinib BID orally on Days 1 through 28 of a 28-day cycle. The treatment was continued until participants experienced a progressive disease, unacceptable toxicity, or other protocol-defined reason for discontinuation.
Interventions
NameTypeDescription
SelpercatinibDRUGAdministered orally
CabozantinibDRUGAdministered orally
VandetanibDRUGAdministered orally
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Eligibility Criteria
Age Range12 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites143

* At least 18 years of age (participants as young as 12 years of age will be allowed if permitted by local regulatory authorities). * Histologically or cytologically confirmed, unresectable, locally advanced and/or metastatic MTC and no prior history of treatment with kinase inhibitors for advanced/...

Countries:United StatesAustraliaBelgiumBrazilCanadaChinaCzechiaFranceGermanyGreeceIndiaIsraelItalyJapanNetherlandsPolandRussiaSouth KoreaSpainUnited KingdomDenmark
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Recent Changes (Last 90 Days)
LOWMay 26, 2026NCT04211337primaryCompletionDate: changed
LOWMay 26, 2026NCT03899792primaryCompletionDate: changed
LOWMay 24, 2026NCT04211337studyFirstPostDate: changed
LOWMay 24, 2026NCT03899792studyFirstPostDate: changed