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A fourth-line GIST drug that locks KIT in an off state regardless of which resistance mutation the tumour has acquired.
INVICTUS: PFS 6.3 vs 1.0 months vs placebo (HR 0.15), OS HR 0.36; approved May 2020 after ≥3 TKIs. INTRIGUE (second line vs sunitinib) not superior overall but superior in KIT exon 11 + 17/18 mutations, prompting INSIGHT (ctDNA-selected phase 3, positive on PFS 2025-26 per interim reports). Deciphera/Ono.
Binds the switch pocket and activation loop of KIT/PDGFRA, inhibiting primary and secondary mutations (exons 9, 11, 13, 14, 17, 18). Connects to KIT.
1.Ripretinib slips into a pocket on KIT.
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026).
Covered for FDA-labelled and NCCN-listed uses, but almost always behind prior authorisation confirming diagnosis, biomarker and line of therapy; dispensed through a specialty pharmacy. Three or more prior kinase inhibitors for GIST.
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE TA1146. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
| Date | Deal | Type | Upfront | Total | Source |
|---|---|---|---|---|---|
| 2024-04-29 | Deciphera Pharmaceuticals (Ono) to Ono Pharmaceutical Ripretinib (Qinlock) and vimseltinib | Acquisition | not disclosed | $2.4bn | source |
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INVICTUS
Label updated with INTRIGUE data
| Region | Year | Indication |
|---|---|---|
| US | 2020 | Advanced GIST after ≥3 prior kinase inhibitors including imatinib |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Alopecia | 52% | - |
| Palmar-plantar erythrodysaesthesia | 21% | - |
| Hypertension | - | 4% |
| Cutaneous squamous cell carcinoma | 4.7% | - |
INVICTUS. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
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Sunitinib remains the standard second-line treatment, with ripretinib as a better-tolerated alternative, and mutation-guided choice by circulating tumour DNA is being tested prospectively in INSIGHT.
Ripretinib is the approved fourth-line treatment for GIST and is being tested earlier in mutation-selected patients (INSIGHT).
Query for this drug: (TITLE:"Ripretinib" OR ABSTRACT:"Ripretinib" OR TITLE:"Qinlock" OR ABSTRACT:"Qinlock") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Ripretinib, not a curated reading list.
Shares INTRIGUE: ripretinib versus sunitinib in advanced gastrointestinal stromal tumour after imatinib, Imatinib-resistant GIST, Gastrointestinal stromal tumour (GIST), Sarcomas (soft tissue, bone, GIST).
Shares PDGFRA, KIT exon 11-mutant GIST, Imatinib-resistant GIST, KIT.
Shares A Study of Inlexisertib (DCC-3116) in Combination With Anticancer Therapies in Participants With Advanced Malignancies, Deciphera Pharmaceuticals (Ono).
Shares KIT exon 11-mutant GIST, Imatinib-resistant GIST, Gastrointestinal stromal tumour (GIST).
Shares PDGFRA, KIT exon 11-mutant GIST, Imatinib-resistant GIST, KIT.
Shares KIT exon 11-mutant GIST, Imatinib-resistant GIST, KIT, Gastrointestinal stromal tumour (GIST).
Shares KIT exon 11-mutant GIST, Imatinib-resistant GIST, Gastrointestinal stromal tumour (GIST).
Shares Imatinib-resistant GIST, Gastrointestinal stromal tumour (GIST), Sarcomas (soft tissue, bone, GIST), Small-molecule kinase inhibitors.