# NAVIGATOR: avapritinib in advanced PDGFRA D842V-mutant gastrointestinal stromal tumour

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

## TL;DR

Avapritinib shrank tumours in almost nine in ten patients with PDGFRA D842V-mutant gastrointestinal stromal tumour, a subtype completely resistant to imatinib and every other kinase inhibitor, and became its first effective treatment.

## Summary

Phase 1 dose-escalation and expansion study; this analysis covers 56 patients with PDGFRA D842V-mutant advanced GIST treated with avapritinib at 300 or 400 mg daily.

Objective response was 88 percent (9 percent complete), median duration of response not reached, and 12-month progression-free survival 81 percent; cognitive effects, periorbital oedema and anaemia were the characteristic toxicities, with rare intracranial bleeding.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet Oncology
- Year: 2020
- DOI: 10.1016/S1470-2045(20)30269-2
- Authors: Heinrich MC, Jones RL, von Mehren M, et al.
- Findings: Objective response 88 percent in PDGFRA D842V-mutant GIST.; Twelve-month progression-free survival 81 percent.
- What it means: Avapritinib 300 mg is the standard first-line treatment for advanced PDGFRA D842V GIST, and mutation testing before starting imatinib is essential to identify these patients.
- Caveats: Single-arm; cognitive side effects need monitoring and dose adjustment.; In non-D842V GIST avapritinib was not superior to regorafenib (VOYAGER).

## Sources

- Lancet Oncol 2020: https://doi.org/10.1016/S1470-2045(20)30269-2
- PubMed: https://pubmed.ncbi.nlm.nih.gov/32615108/

## Connected records

- cancers: [PDGFRA D842V-mutant GIST](https://onco.cc/cancers/gist-pdgfra-d842v/)
- drugs: [Avapritinib](https://onco.cc/drugs/avapritinib/)
- trials: [NAVIGATOR](https://onco.cc/trials/navigator/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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