PDF icon Download PDF
Open Access
CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1811940
Case Report with Review of Literature

Ripretinib in Advanced Gastrointestinal Stromal Tumors: A Case Series and Literature Review from a Tertiary Cancer Center in India

Ventrapragada Neelima
1   Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
,
Shubham Sahni
1   Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
,
Mangu Srinivas Bharadwaj
2   Department of Nuclear Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
,
Shamim Ahmed Shamim
3   Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Sameer Rastogi
1   Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations
› Further Information
Also available ateRef
  Permissions and Reprints
Preview

Abstract

The therapeutic armamentarium for advanced gastrointestinal stromal tumors (GISTs) is rapidly evolving and demands personalized strategies due to its increasing complexity. We are witnessing an expansion of the treatment modalities with new molecules being added to the same. Novel agents such as avapritinib and ripretinib have been granted Food and Drug Administration approval for platelet-derived growth factor α-D842V-mutant and refractory GIST patients, respectively. Ripretinib received its approval in May 2020 for individuals with advanced GIST who had been treated with three or more kinase inhibitors after publication of results of the INVICTUS trial. Here, we share our experience of four patients with previously treated advanced GIST who received ripretinib through an expanded access program. Our favorable experience with ripretinib warrants wider availability and easy accessibility of this drug in India for improving outcomes of patients with GIST.

Keywords

advanced GIST - ripretinib - case series

Note

The manuscript has been read and approved by all the authors and each author believes that the manuscript represents honest work.


Authors' Contributions

The concept, design, and manuscript review were carried out by S.R. Literature search, statistical analysis, and manuscript preparation were performed by V.N. Manuscript preparation was additionally contributed by M.S.B. and S.A.S., while S.S. was responsible for manuscript editing and review.


Patients' Consent

Verbal and written informed consent from the patient/patients for the inclusion of their medical and treatment history within this case report have been obtained.




Publication History

Article published online:
19 September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Blay JY. A decade of tyrosine kinase inhibitor therapy: historical and current perspectives on targeted therapy for GIST. Cancer Treat Rev 2011; 37 (05) 373-384
    CrossrefPubMedSearch in Google Scholar
  • 2 Gastrointestinal Stromal Tumor Meta-Analysis Group (MetaGIST). Comparison of two doses of imatinib for the treatment of unresectable or metastatic gastrointestinal stromal tumors: a meta-analysis of 1,640 patients. J Clin Oncol 2010; 28 (07) 1247-1253
    CrossrefPubMedSearch in Google Scholar
  • 3 Gounder MM, Maki RG. Molecular basis for primary and secondary tyrosine kinase inhibitor resistance in gastrointestinal stromal tumor. Cancer Chemother Pharmacol 2011; 67 (Suppl 1, Suppl 1): S25-S43
    CrossrefPubMedSearch in Google Scholar
  • 4 Demetri GD, van Oosterom AT, Garrett CR. et al. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: a randomised controlled trial. Lancet 2006; 368 (9544): 1329-1338
    CrossrefPubMedSearch in Google Scholar
  • 5 Demetri GD, Reichardt P, Kang YK. et al; GRID study investigators. Efficacy and safety of regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib (GRID): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet 2013; 381 (9863): 295-302
    CrossrefPubMedSearch in Google Scholar
  • 6 Heinrich MC, Jones RL, von Mehren M. et al. Avapritinib in advanced PDGFRA D842V- mutant gastrointestinal stromal tumour (NAVIGATOR): a multicentre, open-label, phase 1 trial. Lancet Oncol 2020; 21 (07) 935-946
    CrossrefPubMedSearch in Google Scholar
  • 7 Smith BD, Kaufman MD, Lu WP. et al. Ripretinib (DCC-2618) is a switch control kinase inhibitor of a broad spectrum of oncogenic and drug-resistant KIT and PDGFRA variants. Cancer Cell 2019; 35 (05) 738-751.e9
    CrossrefPubMedSearch in Google Scholar
  • 8 Janku F, Abdul Razak AR, Chi P. et al. Switch control inhibition of KIT and PDGFRA in patients with advanced gastrointestinal stromal tumor: a phase I study of ripretinib. J Clin Oncol 2020; 38 (28) 3294-3303
    CrossrefPubMedSearch in Google Scholar
  • 9 Blay JY, Serrano C, Heinrich MC. et al. Ripretinib in patients with advanced gastrointestinal stromal tumours (INVICTUS): a double-blind, randomised, placebo- controlled, phase 3 trial. Lancet Oncol 2020; 21 (07) 923-934
    CrossrefPubMedSearch in Google Scholar
  • 10 Zalcberg JR, Heinrich MC, George S. et al. Clinical benefit of ripretinib dose escalation after disease progression in advanced gastrointestinal stromal tumor: an analysis of the INVICTUS study. Oncologist 2021; 26 (11) e2053-e2060
    CrossrefPubMedSearch in Google Scholar
  • 11 Bauer S, Jones RL, Blay JY. et al. Ripretinib versus sunitinib in patients with advanced gastrointestinal stromal tumor after treatment with imatinib (INTRIGUE): a randomized, open-label, phase III trial. J Clin Oncol 2022; 40 (34) 3918-3928
    CrossrefPubMedSearch in Google Scholar
  • 12 Kang YK, Ryu MH, Yoo C. et al. Resumption of imatinib to control metastatic or unresectable gastrointestinal stromal tumours after failure of imatinib and sunitinib (RIGHT): a randomised, placebo-controlled, phase 3 trial. Lancet Oncol 2013; 14 (12) 1175-1182
    CrossrefPubMedSearch in Google Scholar
  • 13 Heinrich MC, Jones RL, George S. et al. Ripretinib versus sunitinib in gastrointestinal stromal tumor: ctDNA biomarker analysis of the phase 3 INTRIGUE trial. Nat Med 2024; 30 (02) 498-506
    CrossrefPubMedSearch in Google Scholar
  • 14 George S, Blay JY, Chi P. et al. The INSIGHT study: a randomized, Phase III study of ripretinib versus sunitinib for advanced gastrointestinal stromal tumor with KIT exon 11 + 17/18 mutations. Future Oncol 2024; 20 (27) 1973-1982
    CrossrefPubMedSearch in Google Scholar