# INTRIGUE: ripretinib versus sunitinib in advanced gastrointestinal stromal tumour after imatinib

Source: https://onco.cc/key-papers/paper-intrigue-ripretinib-vs-sunitinib-jco-2022/  
OnCo record `paper-intrigue-ripretinib-vs-sunitinib-jco-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Ripretinib was not better than sunitinib as second-line treatment for gastrointestinal stromal tumour overall, but it was better tolerated and worked better in tumours with KIT exon 11 plus exon 17/18 secondary mutations, while sunitinib was better for exon 13/14 mutations.

## Summary

Phase 3 open-label trial of 453 patients with advanced GIST after imatinib randomised to ripretinib or sunitinib.

Median progression-free survival was 8.3 versus 7.0 months in the intention-to-treat population (hazard ratio 0.91, not superior); ripretinib had fewer grade 3 to 4 adverse events (41 versus 66 percent) and better quality of life. Circulating tumour DNA analysis showed ripretinib superior in exon 11 plus 17/18 mutations and sunitinib superior in exon 11 plus 13/14 mutations.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Journal of Clinical Oncology
- Year: 2022
- DOI: 10.1200/JCO.22.00294
- Authors: Bauer S, Jones RL, Blay JY, et al.
- Findings: Median progression-free survival 8.3 vs 7.0 months; hazard ratio 0.91 (not superior).; Exon 17/18 secondary mutations: ripretinib 14.2 vs 1.5 months; exon 13/14: sunitinib 15.0 vs 4.0 months.
- What it means: 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.
- Caveats: Failed its primary superiority endpoint.; Mutation subgroup analysis was exploratory.

## Sources

- J Clin Oncol 2022: https://doi.org/10.1200/JCO.22.00294
- PubMed: https://pubmed.ncbi.nlm.nih.gov/35947817/

## Connected records

- cancers: [Imatinib-resistant GIST](https://onco.cc/cancers/gist-imatinib-resistant/)
- drugs: [Imatinib](https://onco.cc/drugs/imatinib/), [Ripretinib](https://onco.cc/drugs/ripretinib/), [Sunitinib](https://onco.cc/drugs/sunitinib/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

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