The reason for this study is to see if the study drug selpercatinib is safe and more effective compared to a standard treatment in participants with rearranged during transfection (RET)-mutant medullary thyroid cancer (MTC) that cannot be removed by surgery or has spread to other parts of the body. Participants who are assigned to the standard treatment and discontinue due to progressive disease have the option to potentially crossover to selpercatinib.



Eligible Ages
Over 12 Years
Eligible Genders
Accepts Healthy Volunteers


- 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/metastatic disease.

- Radiographic progressive disease per Response Evaluation Criteria in Solid Tumors
(RECIST) 1.1 at screening compared with a previous image taken within the prior 14
months as assessed by the BICR. Participants with measurable or non-measurable but
evaluable disease are eligible; however, participants with non-measurable disease may
not have disease limited to bone sites only.

- A defined/acceptable RET gene alteration identified in a tumor, germline
deoxyribonucleic acid (DNA) or blood sample.

- Tumor tissue in sufficient quantity to allow for retrospective central analysis
of RET mutation status

- Eastern Cooperative Oncology Group performance status score of 0 to 2.

- Adequate hematologic, hepatic, and renal function and electrolytes.

- Men and women of childbearing potential must agree to use a highly effective
contraceptive method during treatment with study drug and for 4 months following the
last dose of study drug.

- Ability to swallow capsules.

Exclusion Criteria:

- An additional validated oncogenic driver in MTC if known that could cause resistance
to selpercatinib treatment. Examples include, but are not limited to RAS or BRAF gene
mutations and NTRK gene fusions.

- Symptomatic central nervous system (CNS) metastases, leptomeningeal carcinomatosis, or
untreated spinal cord compression.

- Clinically significant active cardiovascular disease or history of myocardial
infarction within 6 months, history of Torsades de pointes, or prolongation of the
QTcF >470 milliseconds on more than one electrocardiogram (ECG) during screening.
Participants who are intended to receive vandetanib if randomized to the control arm
ineligible if QTcF is >450 milliseconds.

- Active uncontrolled systemic bacterial, viral, or fungal infection or serious ongoing
uncontrolled intercurrent illness.

- Active hemorrhage or at significant risk for hemorrhage.

- Other malignancy unless nonmelanoma skin cancer, carcinoma in situ or malignancy
diagnosed ≥2 years previously and not currently active. Participants with multiple
endocrine neoplasia type 2 (MEN2) associated pheochromocytoma may be eligible.

Study Design

Phase 3
Study Type
Intervention Model
Parallel Assignment
Primary Purpose
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Selpercatinib given orally.
  • Drug: Selpercatinib
    Administered orally
    Other names:
    • LY3527723
    • LOXO-292
Active Comparator
Cabozantinib or Vandetanib
Cabozantinib or vandetanib given orally.
  • Drug: Cabozantinib
    Administered orally
  • Drug: Vandetanib
    Administered orally

Recruiting Locations

Massachusetts General Hospital
Boston, Massachusetts 02114

More Details

Loxo Oncology, Inc.

Study Contact

There will be multiple sites in this clinical trial. 1-877-CTLILLY (1-877-285-4559) or


Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.