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Avapritinib failed to beat regorafenib in unselected later-line GIST, confining it to the PDGFRA D842V niche.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Shares Blueprint Medicines, PDGFRA D842V-mutant GIST, Avapritinib, Sarcomas (soft tissue, bone, GIST).
Shares Blueprint Medicines, Avapritinib, Small-molecule kinase inhibitors.
Shares PDGFRA D842V-mutant GIST, Avapritinib.
Shares PDGFRA D842V-mutant GIST, Avapritinib.
Shares PDGFRA D842V-mutant GIST, Avapritinib.
Shares PDGFRA D842V-mutant GIST, Avapritinib, Sarcomas (soft tissue, bone, GIST), Small-molecule kinase inhibitors.
Shares Blueprint Medicines, Small-molecule kinase inhibitors.