Ripretinib in treatment of repeatedly relapsing rectal gastrointestinal stromal tumor: a case report

Abstract

Gastrointestinal stromal tumor (GIST) is the most common type of gastrointestinal mesenchymal tumor. Fewer than 2% of patients with metastatic GIST treated with imatinib experience a pathologic complete response. Furthermore, response to imatinib and subsequent-line tyrosine kinase inhibitor is limited by most patients developing drug resistance; median time to progression is 2 years for imatinib, and about half a year for sunitinib and regorafenib. In recent years, ripretinib, a fourth-line medicine, is been of the most important advances in the treatment of GIST. The ripretinib in patients with advanced gastrointestinal stromal tumours (INVICTUS): a double-blind, randomised, placebo-controlled, phase 3 trial study showed that ripretinib can significantly reduce the risk of disease progression and mortality in patients with advanced GIST ≥4 lines, and has obvious clinical activity for a variety of KIT/ platelet-derived growth factor receptor α (PDGFR α) gene mutations. This paper presents a case of advanced rectal GIST treated with ripretinib in China. In the years preceding, the patient did not respond well to first-third line agent therapies. However, a partial remission (PR) of the tumor was found after 3-courses of ripretinib treatment. For GIST patients with drug-resistant mutations (both primary and secondary), treatment may be a more accurate and reasonable when mutation-inhibitor agents are prescribed at an early stage.

Ultrasound-guided microwave ablation for a rectal stromal tumor: a rare-case description

“…However, due to the common emergence of drug resistance, the therapeutic effect of IM can be limited, and about 15% of patients with GISTs do not respond to this drug. For patients with IM resistance, second-and third-generation TKIs can be used, but some patients remain resistant to them (3)(4)(5). For these patients, interventional radiology techniques, including hepatic artery embolization, hepatic artery chemoembolization, and radiofrequency are alternative methods (6,7).…”