# VOYAGER

Source: https://onco.cc/trials/voyager/  
OnCo record `voyager` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Avapritinib failed to beat regorafenib in unselected later-line GIST, confining it to the PDGFRA D842V niche.

## Summary

VOYAGER, trial NCT03465722 sponsored by Blueprint Medicines and published in JCO in 2021, found that avapritinib failed to beat regorafenib in unselected third- or fourth-line gastrointestinal stromal tumour, confining the drug to its PDGFRA D842V niche. It randomised 476 patients and did not meet its primary progression-free survival endpoint despite a higher response rate. OnCo links it to sarcomas and GIST and to avapritinib. Avapritinib's GIST label remains limited to PDGFRA exon 18 mutations, and whether potent inhibitors of one mutation class can ever compete in genetically unselected populations is the lesson and the open question.

## Fields

- Kind: Trial
- Status: negative
- Last checked: 2026-09-07
- Tags: lesson:patient-selection
- Registry id: NCT03465722
- Phase: 3
- Setting: Third/fourth-line GIST: avapritinib vs regorafenib
- Sponsor: Blueprint Medicines
- Enrolled: 476
- Result: PFS HR 1.25 (negative).
- Outcomes: Progression-free survival (median): Avapritinib 4.2 months vs Regorafenib 5.6 months, HR 1.25

## Sources

- ClinicalTrials.gov NCT03465722: https://clinicaltrials.gov/study/NCT03465722

## Connected records

- cancers: [PDGFRA D842V-mutant GIST](https://onco.cc/cancers/gist-pdgfra-d842v/), [Sarcomas (soft tissue, bone, GIST)](https://onco.cc/cancers/sarcoma/)
- technologies: [Small-molecule kinase inhibitors](https://onco.cc/technologies/kinase-inhibitors/)
- drugs: [Avapritinib](https://onco.cc/drugs/avapritinib/)
- companies: [Blueprint Medicines](https://onco.cc/companies/blueprint-medicines/)

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JSON: https://onco.cc/api/v1/entities/voyager.json