Emerging drugs for the treatment of gastrointestinal stromal tumors

INTRODUCTION: Oncogenic activation of KIT or PDGFRA receptor tyrosine kinases is the crucial event in gastrointestinal stromal tumor (GIST) biology. Seminal works during the past two decades have underscored, first, the continuous relevance of KIT/PDGFRA oncogenic signaling after progression to targeted inhibition; second, the heterogeneity of KIT/PDGFRA acquired mutations, that cannot be efficiently suppressed by any given tyrosine kinase inhibitor (TKI); and third, the presence of specific mutants highly resistant to all approved therapies.

AREAS COVERED: This review discusses treatment options in advanced/metastatic GIST, including a detailed dissection of ripretinib and avapritinib, the two novel small molecule inhibitors approved by the Food and Drug Administration in 2020.

EXPERT OPINION: The three only therapeutic options since 2012 for metastatic GIST patients were imatinib, sunitinib, and regorafenib. Although imatinib was highly effective in treatment-naïve GIST, the benefit of second- and third-line sunitinib and regorafenib was modest, thus emphasizing the medical need for new treatment options. Ripretinib, a switch control inhibitor with broad anti-KIT/PDGFRA activity, has been approved as ≥4th line in GIST after progression to all standard therapies. Avapritinib, a type I TKI highly specific against the multi-resistant PDGFRA D842V mutation, is approved in this specific subset of GIST patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:26

Enthalten in:

Expert opinion on emerging drugs - 26(2021), 1 vom: 16. März, Seite 53-62

Sprache:

Englisch

Beteiligte Personen:

Pilco-Janeta, Daniel F [VerfasserIn]
García-Valverde, Alfonso [VerfasserIn]
Gomez-Peregrina, David [VerfasserIn]
Serrano, César [VerfasserIn]

Links:

Volltext

Themen:

Antineoplastic Agents
Avapritinib
GIST
Imatinib
Journal Article
Protein Kinase Inhibitors
Research Support, Non-U.S. Gov't
Review
Ripretinib
Sarcoma
Tyrosine kinase inhibitor

Anmerkungen:

Date Completed 02.09.2021

Date Revised 02.09.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1080/14728214.2021.1896704

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM32203244X