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Opinion|Videos|April 14, 2025

INVICTUS Trial: Ripretinib in Fourth-Line Setting

Author(s)Breelyn Wilky, MD, Jason Sicklick, MD, FACS, Seth M. Pollack, MD

Experts discuss the key efficacy and safety findings from the INVICTUS trial that established ripretinib in the fourth-line setting, and how the inclusion of ripretinib has influenced their approach to managing patients with heavily pretreated gastrointestinal stromal tumors (GIST).

Episodes in this series

EP. 1 Optimizing TKI Selection and Sequencing Strategies in Advanced GIST Beyond First-Line Therapy

EP. 1 Optimizing TKI Selection and Sequencing Strategies in Advanced GIST Beyond First-Line Therapy

EP. 2 Biological Mechanisms of GIST Resistance and Tumor Heterogeneity

EP. 2 Biological Mechanisms of GIST Resistance and Tumor Heterogeneity

EP. 3 Monitoring Tumor Heterogeneity and Detecting Resistance

EP. 3 Monitoring Tumor Heterogeneity and Detecting Resistance

EP. 4 Post-Imatinib Progression: Decision Factors and Treatment Options

EP. 4 Post-Imatinib Progression: Decision Factors and Treatment Options

EP. 5 INVICTUS Trial: Ripretinib in Fourth-Line Setting

EP. 5 INVICTUS Trial: Ripretinib in Fourth-Line Setting

EP. 6 INTRIGUE Trial: Key Findings in Second-Line Setting

EP. 6 INTRIGUE Trial: Key Findings in Second-Line Setting

EP. 7 ctDNA Biomarkers in INTRIGUE: Understanding Resistance Patterns

EP. 7 ctDNA Biomarkers in INTRIGUE: Understanding Resistance Patterns

EP. 8 Managing Adverse Events With Different TKIs

EP. 8 Managing Adverse Events With Different TKIs

EP. 9 Next-Generation Treatment Strategies for GIST: Evaluating Combination Therapies and Mutation-Specific Approaches

EP. 9 Next-Generation Treatment Strategies for GIST: Evaluating Combination Therapies and Mutation-Specific Approaches

EP. 10 Practical Recommendations for Community Oncologists

EP. 10 Practical Recommendations for Community Oncologists

Video content above is prompted by the following:

The INVICTUS trial established ripretinib in the fourth-line setting. Could you review the key efficacy and safety findings from this pivotal study? Please also comment on how ripretinib changed your approach to managing patients with heavily pretreated GIST.
So we've seen how ripretinib demonstrated significant efficacy in the fourth-line setting in INVICTUS. Building on this success, the INTRIGUE trial was designed to evaluate ripretinib earlier in the treatment sequence, specifically in the second-line setting compared to standard sunitinib. Before we discuss those data, I'd like to present a case that will help illustrate the challenges of treatment selection after first-line progression and set the stage for our discussion of the INTRIGUE results.

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