Advice and Future Directions for the Treatment of GIST

Edwin Choy, MD, director of the Sarcoma Program at the Division of Hematology Oncology at Massachusetts General Hospital, a founding member of Mass General Brigham, associate professor of medicine at Harvard Medical School, provides key recommendations for community oncologists treating patients with gastrointestinal stromal tumor (GIST).

In the past 2 decades, the FDA has granted a number approvals for the treatment of GIST, including sunitinib (Sutent), regorafenib (Stivarga), ripretinib (Qinlock), avapritinib (Ayvakit), and more.

With the variety of treatments now available, Choy notes that research must now focus on how to properly sequence the therapies. Another area of research that is needed is to focus on which treatment will be the most effective option in the second- and third-line settings.

Transcription:

0:10 | The universe of GIST and the scientists that do research on GIST have to be applauded for creating 5 drugs that can be effective for this disease in the last 20 years. Now, I think the trials have to better understand how to use them and in what sequence. You will see more trials like this where we're trying to see which of the 5 drugs or which of the remaining 4 drugs are going to be most effective in the second-line setting and the third-line setting.

0:46 | Then ultimately, we'll have patients who go through all 5 drugs and have nothing else that they can use. That is an area of unmet need for patients with metastasis GIST. There is some research that may be going back and recycling some of these old medicines that they used before to see if they can also be effective. But there are also other drugs that we know can work on GIST that are not FDA-approved. Perhaps some of those drugs will also be included in these future clinical trials.