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| Gene | RET |
| Variant | V804L |
| Impact List | missense |
| Protein Effect | gain of function |
| Gene Variant Descriptions | RET V804L lies within the protein kinase domain of the Ret protein (UniProt.org). V804L confers a gain of function on the Ret protein, as indicated by increased kinase activity, cell transformation (PMID: 9242375), and is considered a gatekeeper mutation due to lack of response to some inhibitors, including cabozantinib and vandetanib (PMID: 27712045). |
| Associated Drug Resistance | Y |
| Category Variants Paths |
RET mutant RET act mut RET V804L RET mutant RET V804X RET V804L |
| Transcript | NM_020975.6 |
| gDNA | chr10:g.43119548G>C |
| cDNA | c.2410G>C |
| Protein | p.V804L |
| Source Database | RefSeq |
| Genome Build | GRCh38/hg38 |
| Transcript | gDNA | cDNA | Protein | Source Database | Genome Build |
|---|---|---|---|---|---|
| NM_020630.5 | chr10:g.43119548G>C | c.2410G>C | p.V804L | RefSeq | GRCh38/hg38 |
| NM_001406760.1 | chr10:g.43119548G>C | c.2410G>C | p.V804L | RefSeq | GRCh38/hg38 |
| NM_020975 | chr10:g.43119548G>C | c.2410G>C | p.V804L | RefSeq | GRCh38/hg38 |
| NM_020630 | chr10:g.43119548G>C | c.2410G>C | p.V804L | RefSeq | GRCh38/hg38 |
| NM_001406759.1 | chr10:g.43119548G>C | c.2410G>C | p.V804L | RefSeq | GRCh38/hg38 |
| NM_001406744.1 | chr10:g.43119548G>C | c.2410G>C | p.V804L | RefSeq | GRCh38/hg38 |
| NM_020975.5 | chr10:g.43119548G>C | c.2410G>C | p.V804L | RefSeq | GRCh38/hg38 |
| NM_020630.7 | chr10:g.43119548G>C | c.2410G>C | p.V804L | RefSeq | GRCh38/hg38 |
| NM_020975.6 | chr10:g.43119548G>C | c.2410G>C | p.V804L | RefSeq | GRCh38/hg38 |
| NM_001406743.1 | chr10:g.43119548G>C | c.2410G>C | p.V804L | RefSeq | GRCh38/hg38 |
| Molecular Profile | Indication/Tumor Type | Response Type | Therapy Name | Approval Status | Evidence Type | Efficacy Evidence | References |
|---|---|---|---|---|---|---|---|
| RET V804L | Advanced Solid Tumor | sensitive | Ponatinib | Preclinical | Actionable | In a preclinical study, transformed human cell lines expressing RET V804L demonstrated sensitivity to Iclusig (ponatinib) (PMID: 23811235). | 23811235 |
| RET V804L | Advanced Solid Tumor | resistant | Vandetanib | Preclinical | Actionable | In a preclinical study, transformed cells expressing RET V804L demonstrated resistance to growth inhibition by Caprelsa (vandetanib) in culture (PMID: 15184865). | 15184865 |
| RET V804L | Advanced Solid Tumor | predicted - sensitive | Pz-1 | Preclinical | Actionable | In a preclinical study, Pz-1 inhibited Ret phosphorylation in transformed cells expressing RET V804L (PMID: 26126987). | 26126987 |
| RET V804L | medullary thyroid carcinoma | sensitive | Selpercatinib | FDA approved | Actionable | In a Phase I/II trial (LIBRETTO-001) that supported FDA approval, Retevmo (selpercatinib) treatment resulted in an objective response rate (ORR) of 69% (38/55, 5 complete and 33 partial responses) in previously treated and an ORR of 73% (64/88) in treatment naive adult and pediatric patients of 12 years and older with medullary thyroid cancer harboring RET mutations, including RET V804M/L (n=11) (PMID: 32846061; NCT03157128). | detail... 32846061 |
| RET V804L | medullary thyroid carcinoma | sensitive | Selpercatinib | Case Reports/Case Series | Actionable | In a Phase I/II trial (LIBRETTO-001), Retevmo (selpercatinib) treatment resulted in an objective response in three patients (3/5) and stable disease in two patients (2/5) with medullary thyroid cancer harboring RET V804L or RET V804M who had been treated previously (PMID: 32846061; NCT03157128). | 32846061 |
| RET V804L | Advanced Solid Tumor | predicted - sensitive | APS03118 | Preclinical - Biochemical | Actionable | In a preclinical study, APS03118 inhibited the enzymatic activity of RET V804L in an in vitro assay (J Clin Oncol 40, no. 16_suppl (June 1, 2022)). | detail... |
| RET V804L | Advanced Solid Tumor | predicted - sensitive | TY-1091 | Preclinical - Biochemical | Actionable | In a preclinical study, TY-1091 inhibited activity in a cell line expressing RET V804L in culture (Cancer Res (2023) 83 (7_Supplement): 3419). | detail... |