Rearranged during transfection (RET) proto-oncogene gene fusions are rare in non–small-cell lung cancer (NSCLC), about 1-2%. RET-rearranged tumours have been shown to respond to tyrosine kinase inhibitors, such as cabozantinib, vandetanib. Several clinical trials also has been undergoing. In the real word, RET fusion patients characteristics, treatment options and outcomes are still not clear. A retrospective, single center study of patients with pathologically confirmed NSCLC was conducted. RET rearrangements were detected using next generation sequencing (NGS). We analyzed the clinical characteristics of patients with RET-rearranged NSCLC and the efficacy of therapeutic regimens. We also evaluated the RET-rearranged patients survival outcomes, PFS of first-line therapy (PFS1), and second line therapy (PFS2). From 9/July/ 2017 to 25/Nov/2019, Total 3217 NSCLC patients were screened for RET-rearranged testing, only 41 (1.3%) patients had RET fusion gene, including 23 KIF5B-RET,10 CCDC6-RET and 8 other RET fusion gene. The average age was 60 years old (30-85). Of the 41 patients, 23(56%) females and 18 males, 36(87.8%) never smoker, 5 heavy smokers and no light smokers, 39(95%) adenocarcinoma and 2 squamous carcinoma. Most (33/41) of them had advanced stage (IIIB/IIIC/IV) . the majority (35/41) of patients had lymph node metastasis, especially in mediastinum, neck, supraclavicular, and axillary regions. Significantly, the axillary lymph node metastasis reached 12% (4/33). The common distant metastasis was still brain, bone, liver and adrenal gland. Unfortunately, 9 patients had no treatment records and failed to follow up. 20 patients with stage IIIB to stage IV had accepted first-line treatment, including 17chemotherapy, 2 target therapy, and 1 immunotherapy. The median progression-free survival (PFS1) of first-line chemotherapy was 9.3m (7.0m-11.6m), 2 patients with cabozantinib PFS1 were 3.9m and 6.0m respectively. the only one with duravalumab was 6.0m. There were few patients accepted second line therapy, The PFS2 was 3.0m(1.6m-6.5m). The median OS of all advanced (stage IIIB/IV) patients was 12.0 (6.5m-17.5m). Further analysis found that there were 20 patients accepted one or more lines treatment, while 4 patients had died through non-treatment. The OS of treated and non-treated advanced NSCLC patients were 14.0m and 2.0m respectively.Table 1RET-rearranged NSCLC characteristic and therapeutic outcometotal (n=41)N(%)Treatment outcomeAge,years60(30-85)First-linePFS1Sexchemotherapy9.3 (7.0m-11.6m)female23 (56.0%)target therapy3.9m/6.0mmale18 (44.0%)immunotherapy6.0mSmokeSecond-linePFS2never36 (87.8%)chemotherapy3.0m (1.4m-8.5m)light0target therapy3.0m (1.0m-3.6m)heavy5 (12.2%)OSRET-rearranged siteAll patients12.0m (6.5m-17.5m)KIF5B-RET23 (56.1%)treated14.0m (1.7m-26.2m)CCDC6-RET10 (24.4%)non-treated2.0m (0.4m-3.6m)others8 (19.5%)Pathology typeadenocarcinoma38 (92.7%)sqmous carcinoma2 (4.9%)neuroendocrine tumor1 (2.4%)Lymph node metastasismediastinum20 (47.8%)supraclavicular15 (36.6%)axillary4 (9.8%) Open table in a new tab RET-rearranged NSCLC was more likely to have lymph node metastasis. Because of poor access to target drug of cabozantinib and vandetanib in China, most of RET rearranged non-small cell lung cancer had chosen chemotherapy as first-line therapy, even so, they had a quite acceptable PFS, and overall survival was prolonged.