Related Experiment Video

Updated: Jul 1, 2025

Comparative Lesions Analysis Through a Targeted Sequencing Approach
08:16

Comparative Lesions Analysis Through a Targeted Sequencing Approach

Published on: November 5, 2019

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Outcomes of Late-Line Systemic Treatment in GIST: Does Sequence Matter?

Prapassorn Thirasastr1, Thomas L Sutton2, Cissimol P Joseph1

  • 1Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

Cancers
|March 13, 2024
PubMed

Insights

This study found that both ripretinib and avapritinib are effective for advanced gastrointestinal stromal tumors (GISTs). The order in which these drugs are administered does not impact their efficacy, offering flexibility in GIST treatment sequencing.

Area of Science:

  • Oncology
  • Gastrointestinal Oncology
  • Gastrointestinal Stromal Tumors (GISTs)

Background:

  • Ripretinib and avapritinib are tyrosine kinase inhibitors used in late-line treatment of gastrointestinal stromal tumors (GISTs).
  • Understanding the efficacy of sequential treatment with these agents is crucial for optimizing patient outcomes in advanced GIST.

Purpose of the Study:

  • To investigate the efficacy of ripretinib followed by avapritinib versus avapritinib followed by ripretinib in patients with metastatic or unresectable GIST.
  • To compare time-to-progression (TTP) and overall survival (OS) based on the sequence of drug administration.

Main Methods:

  • Retrospective analysis of 34 patients with metastatic/unresectable GIST treated with both ripretinib and avapritinib at two institutions.
  • Patients were grouped into ripretinib-avapritinib (RA) and avapritinib-ripretinib (AR) sequences.
  • Radiographic response assessed by RECIST 1.1; TTP and OS analyzed using Kaplan-Meier and log-rank tests.

Main Results:

  • No significant differences in baseline characteristics or tumor mutations between the RA and AR groups.
  • Similar response rates for ripretinib (18% RA vs. 12% AR) and avapritinib (12% AR vs. 18% RA).
  • Median TTPs and OS were comparable between the RA and AR sequences, indicating no dependency on drug order.

Conclusions:

  • Both ripretinib and avapritinib demonstrate efficacy in the late-line treatment of GIST.
  • The sequence of administration of ripretinib and avapritinib does not appear to influence treatment efficacy in GIST patients.
  • Findings support treatment flexibility in sequencing these agents for advanced GIST.
Keywords:
avapritinibgastrointestinal stomal tumorripretinib

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