# INVICTUS: ripretinib in advanced gastrointestinal stromal tumours after three or more prior kinase inhibitors

Source: https://onco.cc/key-papers/paper-invictus-ripretinib-lancet-oncol-2020/  
OnCo record `paper-invictus-ripretinib-lancet-oncol-2020` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The switch-control KIT inhibitor ripretinib lengthened progression-free survival from one to six months and improved survival compared with placebo in gastrointestinal stromal tumours that had failed imatinib, sunitinib and regorafenib.

## Summary

Phase 3 placebo-controlled trial of 129 patients with advanced GIST after at least three prior kinase inhibitors randomised 2:1 to ripretinib 150 mg daily or placebo with crossover.

Median progression-free survival was 6.3 versus 1.0 months (hazard ratio 0.15) and median overall survival 15.1 versus 6.6 months (hazard ratio 0.36); alopecia, myalgia and hand-foot syndrome were common and mostly low grade.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet Oncology
- Year: 2020
- DOI: 10.1016/S1470-2045(20)30168-6
- Authors: Blay JY, Serrano C, Heinrich MC, et al.
- Findings: Median progression-free survival 6.3 vs 1.0 months; hazard ratio 0.15.; Median overall survival 15.1 vs 6.6 months; hazard ratio 0.36.
- What it means: Ripretinib is the approved fourth-line treatment for GIST and is being tested earlier in mutation-selected patients (INSIGHT).
- Caveats: Objective response was only 9 percent; benefit is disease stabilisation.; Small trial in a heavily pretreated population.

## Sources

- Lancet Oncol 2020: https://doi.org/10.1016/S1470-2045(20)30168-6
- PubMed: https://pubmed.ncbi.nlm.nih.gov/32511981/

## Connected records

- cancers: [Imatinib-resistant GIST](https://onco.cc/cancers/gist-imatinib-resistant/)
- drugs: [Ripretinib](https://onco.cc/drugs/ripretinib/)
- trials: [INVICTUS](https://onco.cc/trials/invictus/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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