Compassionate Use of Ripretinib for Patients With Metastatic Gastrointestinal Stromal Tumors: Taiwan and Hong Kong Experience

BackgroundRipretinib was recently approved for the fourth-line targeted therapy for advanced gastrointestinal stromal tumor (GIST) refractory to imatinib, sunitinib, and regorafenib based on the pivotal INVICTUS phase III study. The INVICTUS study demonstrated significantly improved median progressi...

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Main Authors: Li-Ching Lin, Wen-Kuan Huang, Chueh-Chuan Yen, Ching-Yao Yang, Meng-Ta Sung, Natalie S. M. Wong, Daniel T. T. Chua, Sarah W. M. Lee, Jen-Shi Chen, Chun-Nan Yeh
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-06-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2022.883399/full
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author Li-Ching Lin
Wen-Kuan Huang
Chueh-Chuan Yen
Chueh-Chuan Yen
Ching-Yao Yang
Meng-Ta Sung
Natalie S. M. Wong
Daniel T. T. Chua
Sarah W. M. Lee
Jen-Shi Chen
Chun-Nan Yeh
author_facet Li-Ching Lin
Wen-Kuan Huang
Chueh-Chuan Yen
Chueh-Chuan Yen
Ching-Yao Yang
Meng-Ta Sung
Natalie S. M. Wong
Daniel T. T. Chua
Sarah W. M. Lee
Jen-Shi Chen
Chun-Nan Yeh
author_sort Li-Ching Lin
collection DOAJ
description BackgroundRipretinib was recently approved for the fourth-line targeted therapy for advanced gastrointestinal stromal tumor (GIST) refractory to imatinib, sunitinib, and regorafenib based on the pivotal INVICTUS phase III study. The INVICTUS study demonstrated significantly improved median progression-free survival (PFS) of 6.3 months and an overall survival (OS) insignificant benefit of ripretinib of 15.1 months as compared with placebo in 85 patients with advanced metastatic GIST. However, treatment outcome for the Chinese population, including in Taiwan and Hong Kong, was lacking.Material and MethodA compassionate study regarding ripretinib use for patients with advanced/metastatic GIST was conducted from March 2020 to March 2021 to assess the treatment efficacy and safety in Taiwan and Hong Kong patients.ResultTwenty evaluable patients (16 men and 4 women) with heavily pretreated metastatic GIST receiving ripretinib from March 2020 to March 2021 were enrolled to evaluate the treatment outcome. The response and clinical benefit rates to ripretinib were 25% (5/20) and 60% (12/20), respectively. The median PFS and OS in this compassionate cohort receiving ripretinib were 6.1 months and not reachable, respectively. Albumin less than 3.5 and disease progression after ripretinib use were the two independent unfavorable factors for PFS. There were 14 out of 20 (70%) experiencing any grade adverse event (AE). Loss of hair is the most common grade I to II AE with an incidence of 55%. Grade III AEs included diarrhea, skin rash, and anemia with one patient (5%) for each AE.ConclusionsLate-line ripretinib use in pretreated Taiwan and Hong Kong patients with advanced GIST showed efficacy consistent with the INVICTUS study. Albumin less than 3.5 and disease progression after ripretinib use were the two independent unfavorable factors for PFS. Ripretinib is generally tolerable, with loss of hair being the most common AE.
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spelling doaj.art-936dc38c75d744dbbab1a54dd00643922022-12-22T02:23:40ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-06-011210.3389/fonc.2022.883399883399Compassionate Use of Ripretinib for Patients With Metastatic Gastrointestinal Stromal Tumors: Taiwan and Hong Kong ExperienceLi-Ching Lin0Wen-Kuan Huang1Chueh-Chuan Yen2Chueh-Chuan Yen3Ching-Yao Yang4Meng-Ta Sung5Natalie S. M. Wong6Daniel T. T. Chua7Sarah W. M. Lee8Jen-Shi Chen9Chun-Nan Yeh10Department of Surgery and GIST Team, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine and GIST Team, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Clinical Research, Department of Medical Research and Division of Medical Oncology, Center for Immuno-oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, TaiwanNational Yang Ming Chiao Tung University School of Medicine, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Oncology, Mennonite Christian Hospital, Haulien, TaiwanDepartment of Clinical Oncology, Tuen Mun Hospital, Hong Kong, Hong Kong SAR, ChinaDepartment of Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong SAR, ChinaDepartment of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, ChinaDivision of Hematology-Oncology, Department of Internal Medicine and GIST Team, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Surgery and GIST Team, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanBackgroundRipretinib was recently approved for the fourth-line targeted therapy for advanced gastrointestinal stromal tumor (GIST) refractory to imatinib, sunitinib, and regorafenib based on the pivotal INVICTUS phase III study. The INVICTUS study demonstrated significantly improved median progression-free survival (PFS) of 6.3 months and an overall survival (OS) insignificant benefit of ripretinib of 15.1 months as compared with placebo in 85 patients with advanced metastatic GIST. However, treatment outcome for the Chinese population, including in Taiwan and Hong Kong, was lacking.Material and MethodA compassionate study regarding ripretinib use for patients with advanced/metastatic GIST was conducted from March 2020 to March 2021 to assess the treatment efficacy and safety in Taiwan and Hong Kong patients.ResultTwenty evaluable patients (16 men and 4 women) with heavily pretreated metastatic GIST receiving ripretinib from March 2020 to March 2021 were enrolled to evaluate the treatment outcome. The response and clinical benefit rates to ripretinib were 25% (5/20) and 60% (12/20), respectively. The median PFS and OS in this compassionate cohort receiving ripretinib were 6.1 months and not reachable, respectively. Albumin less than 3.5 and disease progression after ripretinib use were the two independent unfavorable factors for PFS. There were 14 out of 20 (70%) experiencing any grade adverse event (AE). Loss of hair is the most common grade I to II AE with an incidence of 55%. Grade III AEs included diarrhea, skin rash, and anemia with one patient (5%) for each AE.ConclusionsLate-line ripretinib use in pretreated Taiwan and Hong Kong patients with advanced GIST showed efficacy consistent with the INVICTUS study. Albumin less than 3.5 and disease progression after ripretinib use were the two independent unfavorable factors for PFS. Ripretinib is generally tolerable, with loss of hair being the most common AE.https://www.frontiersin.org/articles/10.3389/fonc.2022.883399/fullripretinibGISTcompassionate useadvancedmetastatic
spellingShingle Li-Ching Lin
Wen-Kuan Huang
Chueh-Chuan Yen
Chueh-Chuan Yen
Ching-Yao Yang
Meng-Ta Sung
Natalie S. M. Wong
Daniel T. T. Chua
Sarah W. M. Lee
Jen-Shi Chen
Chun-Nan Yeh
Compassionate Use of Ripretinib for Patients With Metastatic Gastrointestinal Stromal Tumors: Taiwan and Hong Kong Experience
Frontiers in Oncology
ripretinib
GIST
compassionate use
advanced
metastatic
title Compassionate Use of Ripretinib for Patients With Metastatic Gastrointestinal Stromal Tumors: Taiwan and Hong Kong Experience
title_full Compassionate Use of Ripretinib for Patients With Metastatic Gastrointestinal Stromal Tumors: Taiwan and Hong Kong Experience
title_fullStr Compassionate Use of Ripretinib for Patients With Metastatic Gastrointestinal Stromal Tumors: Taiwan and Hong Kong Experience
title_full_unstemmed Compassionate Use of Ripretinib for Patients With Metastatic Gastrointestinal Stromal Tumors: Taiwan and Hong Kong Experience
title_short Compassionate Use of Ripretinib for Patients With Metastatic Gastrointestinal Stromal Tumors: Taiwan and Hong Kong Experience
title_sort compassionate use of ripretinib for patients with metastatic gastrointestinal stromal tumors taiwan and hong kong experience
topic ripretinib
GIST
compassionate use
advanced
metastatic
url https://www.frontiersin.org/articles/10.3389/fonc.2022.883399/full
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