Ripretinib for the treatment of adult patients with advanced gastrointestinal stromal tumors.
Expert Rev Gastroenterol Hepatol, 2023/2;17(2):119-127.
Sargsyan A[1, 2], Kucharczyk MA[3], Jones RL[3, 4], Constantinidou A[1, 2]
Affiliations
PMID: 36644853DOI: 10.1080/17474124.2023.2167711
Impact factor: 4.095
Abstract
introduction: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. Imatinib mesylate revolutionized the management of advanced/metastatic GIST, and remains the standard first-line therapy in this setting. Upon development of secondary resistance, sunitinib and regorafenib are used as subsequent treatments, although clinical benefit is often non-durable. Ripretinib is a type II kinase inhibitor targeting KIT and PDGFRA mutations and resistance through switching active I and inactive II forms.
areas covered: This drug profile article provides an overview of the current state of the art treatment algorithm for advanced/metastatic GIST, focusing on the role of ripretinib in the fourth-line setting as defined by currently available clinical trials evidence. The mechanism of action, the safety profile, efficacy, and clinical application of ripretinib are presented. In addition, the Phase I study (NCT02571036) through which the optimal dose was established and the Phase III trials that assessed the efficacy and safety of ripretinib as fourth- (INVICTUS) and second-line treatment (INTRIGUE) are presented.
expert opinion: Ripretinib is a safe and an effective therapy for the fourth-line setting in advanced/metastatic GIST. Future studies should evaluate combination schedules and the identification of markers predictive of benefit from ripretinib.
Keywords: Gastrointestinal stromal tumor; KIT; kinase inhibitor; mutations; resistance; ripretinib; systemic treatment
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