Michael C. Heinrich
Oregon physician-scientist who showed that the KIT mutation type in a GIST predicts how well imatinib works, discovered PDGFRA mutations in the tumours without KIT mutations, and led NAVIGATOR, which established avapritinib for PDGFRA D842V disease.
Overview
Michael Heinrich is a medical oncologist and laboratory investigator at Oregon Health & Science University and the Portland VA Medical Center. With Christopher Corless he reported PDGFRA-activating mutations in KIT-negative gastrointestinal stromal tumours in Science in 2003 and showed in the same year that KIT exon 11 mutations predict response to imatinib. He was first author of the 2020 Lancet Oncology report of NAVIGATOR, in which avapritinib produced high response rates in PDGFRA D842V-mutant GIST, an indication resistant to earlier drugs.
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.
Mutation testing is standard before imatinib in GIST: exon 11 tumours receive 400 mg, exon 9 tumours are dosed at 800 mg, and PDGFRA D842V tumours are given avapritinib instead.
PDGFRA testing is part of standard GIST genotyping, and the imatinib resistance of D842V predicted here led to the development of avapritinib.
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