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Gastrointestinal Stromal Tumors (GISTs)

Updated : September 16, 2022





Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

avapritinib 

300

mg

Tablet

Orally 

every day



sunitinib 

sunitinib is indicated to treat GIST (Gastrointestinal Stromal Tumor) in case of disease progression or reported intolerance of imatinib mesylate
50 mg orally each day for four weeks After 2 weeks of drug free stage, repeat the cycle
Continue the medication until the disease reduces



ripretinib 

Take 150 mg orally every day

Dosage Modifications
Dose reduction recommendations
Decrease up to 100 mg every day
If not able to tolerate 100 mg/day: discontinue forever
Left ventricular systolic dysfunction
For Grade 3 or 4: discontinue forever
Palmoplantar erythrodysesthesia syndrome (PPES)
For Grade 2
Stop until Grade ≤1, start again at the similar dose if resolved within 7 days, or else start again at a decreased dose
For Grade 3
Stop for a minimum of 7 days and then again start at a decreased dosage Hypertension
For Grade 3
Grade 3 high blood pressure occurs: Stop until indications cured and blood pressure is managed then start again with lower dose
For Grade 4
Discontinue forever
Arthralgia or myalgia
For Grade 2
Stop until Grade ≤1, start again at the similar dose if resolved within 7 days, or else start again at a decreased dosage
For Grade 3
Stop for a minimum of 7 days and then again start at a decreased dose Renal impairmen
t Mild-to-moderate: No clinical observations found Severe: study not performed Hepatic impairment
Mild, moderate, or severe: dose modification not required CYP3A inducers
Strong CYP3A inducers: stop using Moderate CYP3A inducers: stop using Dosing Considerations
Confirm the pregnancy status of women who have the potential to conceive before commencing.



 
 

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References

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Gastrointestinal Stromal Tumors (GISTs)

Updated : September 16, 2022




avapritinib 

300

mg

Tablet

Orally 

every day



sunitinib 

sunitinib is indicated to treat GIST (Gastrointestinal Stromal Tumor) in case of disease progression or reported intolerance of imatinib mesylate
50 mg orally each day for four weeks After 2 weeks of drug free stage, repeat the cycle
Continue the medication until the disease reduces



ripretinib 

Take 150 mg orally every day

Dosage Modifications
Dose reduction recommendations
Decrease up to 100 mg every day
If not able to tolerate 100 mg/day: discontinue forever
Left ventricular systolic dysfunction
For Grade 3 or 4: discontinue forever
Palmoplantar erythrodysesthesia syndrome (PPES)
For Grade 2
Stop until Grade ≤1, start again at the similar dose if resolved within 7 days, or else start again at a decreased dose
For Grade 3
Stop for a minimum of 7 days and then again start at a decreased dosage Hypertension
For Grade 3
Grade 3 high blood pressure occurs: Stop until indications cured and blood pressure is managed then start again with lower dose
For Grade 4
Discontinue forever
Arthralgia or myalgia
For Grade 2
Stop until Grade ≤1, start again at the similar dose if resolved within 7 days, or else start again at a decreased dosage
For Grade 3
Stop for a minimum of 7 days and then again start at a decreased dose Renal impairmen
t Mild-to-moderate: No clinical observations found Severe: study not performed Hepatic impairment
Mild, moderate, or severe: dose modification not required CYP3A inducers
Strong CYP3A inducers: stop using Moderate CYP3A inducers: stop using Dosing Considerations
Confirm the pregnancy status of women who have the potential to conceive before commencing.



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