Abstract 85P
Background
Ripretinib 150 mg once daily (QD) is indicated as at least fourth-line therapy for advanced gastrointestinal stromal tumors (GISTs). Ripretinib intrapatient dose escalation (IPDE) to 150 mg b.i.d. was recommended after progressive disease (PD) on 150 mg QD by 2022 NCCN and 2022 Guideline of Chinese Society of Clinical Oncology (CSCO). However, the treatment outcome of ripretinib IPDE in Chinese advanced GIST patients was lacking. We reported the efficacy and safety of ripretinib IPDE after PD among advanced GIST patients treated with ripretinib 150 mg QD.
Methods
Patients with a diagnosis of GIST, progression on at least imatinib, sunitinib, and regorafenib, treated with ripretinib IPDE, and at least one efficacy evaluation between June 1st, 2020, and Dec 31st, 2022, were retrospectively analyzed. Clinicopathological characteristics, treatment regimens, and follow-up visit information were collected. Among the ripretinib IPDE patients, progression-free survival (PFS)1 was the time from ripretinib native treatment until PD; PFS2 was the time from the first dose of ripretinib dose escalation to PD or death.
Results
Twelve patients (8 men and 4 women) with advanced GIST receiving ripretinib IPDE were included to evaluate the treatment outcome from 11 hospitals. 10 (83%) patients received ripretinib 150 mg b.i.d and 2 (17%) patients received 200 mg once daily. Median PFS1 was 6.4 months and median PFS2 was 11 months. Median overall survival was not reached. The ORR was 17% and 10% for Ripretinib 150 mg QD treatment and IPDE, respectively. Ripretinib 150 mg QD and IPDE were well tolerated. Patients treated with Ripretinib 150 mg QD were all reported with grade 1-2 treatment-emergent adverse events (TEAEs), and Ripretinib IPED patients were documented with grade 1-2 TEAEs in 11(91.7%) patients and grade 3–4 TEAEs of anemia in 1(8.3%) patient.
Conclusions
Fourth-line ripretinib use in Chinese patients with advanced GIST showed profitable efficacy and safety. Ripretinib dose escalation may be good management for patient failure to ripretinib 150 mg QD. Further clinical studies on ripretinib dose escalation are in need.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.