A Study of Ripretinib vs Sunitinib in Advanced GIST Patients After Treatment With Imatinib (INTRIGUE)
A Phase 3, Interventional, Randomized, Multicenter, Open-Label Study of Ripretinib vs Sunitinib in Patients With Advanced Gastrointestinal Stromal Tumor (GIST) After Treatment With Imatinib
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Buenos Aires, Argentina
- Instituto Medicao Especializado Alexander Fleming
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Córdoba Province
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Córdoba, Córdoba Province, Argentina, X5000JHQ
- Sanatorio Allende
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Woolloongabba, Australia
- Princess Alexandara Hospital
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New South Wales
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Albury, New South Wales, Australia
- Border Medical Oncology Research Unit
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Randwick, New South Wales, Australia, 2031
- Prince of Wales Hospital
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Queensland
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Woolloongabba, Queensland, Australia
- Princess Alexandra Hospital
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South Australia
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Kurralta Park, South Australia, Australia, 5037
- Ashford Cancer Centre Research
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Kurralta Park, South Australia, Australia
- Ashford Cancer Centre Research
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Victoria
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Melbourne, Victoria, Australia, 3004
- The Alfred Hospital
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Brussels, Belgium
- Institut Jules Bordet
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Leuven, Belgium
- UZ Leuven
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Québec, Canada
- Hôpital Maisonneuve-Rosemont
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Alberta
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Edmonton, Alberta, Canada
- Cross Cancer Institute
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Manitoba
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Winnipeg, Manitoba, Canada
- CancerCare Manitoba
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Ontario
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Hamilton, Ontario, Canada
- Juravinski Cancer Centre
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Ottawa, Ontario, Canada
- The Ottawa Hospital Cancer Centre
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Toronto, Ontario, Canada, M5G 2C1
- Princess Margaret Cancer Centre
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Santiago, Chile
- Clinica San Carlos de Apoquindo Red Salud UC Christs
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Prague, Czechia
- Fakultni nemocnice v Motole
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Bordeaux, France
- Institut Bergonnié
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Dijon, France
- Centre Georges Francois Leclerc
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Lille, France
- Centre Oscar Lambret
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Lyon, France
- Centre Léon Bérard
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Marseille, France
- Hôpital la Timone
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Marseille, France
- IPC
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Paris, France
- IGR
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Poitiers, France
- CHU Poitiers-Hopital la Miletrie
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Saint-Herblain, France
- ICO - Site René Gauducheau
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Berlin, Germany
- Helios Klinikum Berlin-Buch
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Dresden, Germany
- Technische Universität Dresden
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Essen, Germany
- West German Cancer Center
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Budapest, Hungary
- Magyar Honvedseg Egeszsegugyi Kozpont
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Debrecen, Hungary
- Debreceni Egyetem
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Be’er Ya‘aqov, Israel
- Shamir Medical Center (Assaf Harofeh)
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Petah Tikva, Israel
- Rabin Medical Cente
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Tel Aviv, Israel
- Tel-Aviv Sourasky Medical Center
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Bologna, Italy
- Azienda Ospedaliera Universitaria Policlinico Sant'Orsola Malpighi
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Meldola, Italy
- stituto Scientifico Romagnolo Per Lo Studio e La Cura Dei Tumori
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Milan, Italy
- Fondazione IRCCS Istituto Nazionale dei Tumori
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Padua, Italy
- Iov - Istituto Oncologico Veneto Irccs
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Palermo, Italy
- Universita degli Studi di Palermo
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Rome, Italy
- Universita Campus Bio-Medico di Roma
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Amsterdam, Netherlands
- The Netherlands Cancer Institute
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Amsterdam, Netherlands
- Antoni van Leeuwenhoek
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Groningen, Netherlands
- University Medical Center Groningen
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Leiden, Netherlands
- Leiden University Medical Centre
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Oslo, Norway
- Oslo University Hospital
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Warsaw, Poland
- Centrum Onkologii-Instytut im. M. Sklodowskiej Curie
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Singapore, Singapore, 169610
- National Cancer Centre
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Seoul, South Korea
- Asan Medical Center
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Seoul, South Korea
- Samsung Medical Center
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Seoul, South Korea
- Seoul National University Hospital
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Suwon, South Korea
- Ajou University Hospital
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Barcelona, Spain
- Hospital Universitari Vall d'Hebron
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Barcelona, Spain
- Hospital de la Santa Creu i Sant Pau
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Bilbao, Spain
- Hospital de Basurto
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Madrid, Spain
- Hospital Universitario 12 de Octubre
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Madrid, Spain
- Hospital Universitario Clínico San Carlos
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Madrid, Spain
- Hospital Universitario La Paz
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Madrid, Spain
- Hospital Universitario Ramon y Cajal
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Madrid, Spain
- Hospital Universitario Hm Madrid Sanchinarro
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Málaga, Spain
- Hospital Clínico Universitario Virgen de la Victoria
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Seville, Spain
- Hospital Universitario Virgen del Rocio
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Valencia, Spain
- Instituto Valenciano de Oncología,
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Vigo, Spain
- Complejo Hospitalario Universitario de Vigo
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Solna, Sweden
- Karolinska Universitetssjukhuset
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Lausanne, Switzerland
- Centre Hospitalier Universitaire Vaudois, Fondation du Centre Pluridisciplinaire d'Oncologi
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Zurich, Switzerland
- Universitaetsspital Zuerich, Klinik fuer Onkologie
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Kaohsiung City, Taiwan
- Kaohsiung Chang Gung Memorial Hospital,
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Taichung, Taiwan
- China Medical University Hospital
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Tainan, Taiwan
- National Chen Kung University Hospital
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Taipei, Taiwan
- Taipei Veterans General Hospital
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Taoyuan County
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Linkou District, Taoyuan County, Taiwan
- Chang Gung Memorial Hospital
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Glasgow, United Kingdom
- Beatson West Of Scotland Cancer Centre
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Leeds, United Kingdom
- St James's University Hospital
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London, United Kingdom
- University College London Hospitals
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London, United Kingdom
- Royal Marsden Hospital - Fulham
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Sheffield, United Kingdom
- Weston Park Hospital
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Arizona
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Scottsdale, Arizona, United States, 85259
- Mayo Clinic Scottsdale
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California
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La Jolla, California, United States, 92103
- University of California San Diego Medical Center
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Los Angeles, California, United States, 90024
- UCLA Hematology Oncology Center - Main Site
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Stanford, California, United States, 94305
- Stanford Medicine
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Colorado
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Aurora, Colorado, United States, 80045
- University of Colorado Hospital - Anschutz Cancer Pavillion
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Denver, Colorado, United States, 80220
- Rocky Mountain Cancer Centers
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Connecticut
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New Haven, Connecticut, United States, 06511
- Smilow Cancer Hospital at Yale
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District of Columbia
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Washington D.C., District of Columbia, United States, 20010
- Washington Cancer Institute at MedStar Washington Hospital Center
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Florida
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Jacksonville, Florida, United States, 32224
- Mayo Clinic Florida
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Miami, Florida, United States, 33176
- Miami Cancer Institute at Baptist Health, Inc.
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Miami, Florida, United States, 33136
- Sylvester Comprehensive Cancer Center
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Orlando, Florida, United States, 32806
- Orlando Health UF Health Cancer Center
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Tampa, Florida, United States, 33612
- Moffitt Cancer Center
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Georgia
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Atlanta, Georgia, United States, 30332
- Winship Cancer Institute
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Sandy Springs, Georgia, United States, 30342
- Georgia Cancer Specialists
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Illinois
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Chicago, Illinois, United States, 60637
- University of Chicago Medical Center
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Chicago, Illinois, United States, 60611
- Northwestern Memorial Hospital
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Indiana
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Indianapolis, Indiana, United States, 46202
- Iu Simon Cancer Center
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Iowa
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Iowa City, Iowa, United States, 52242
- University of Iowa Hospital and Clinics
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Kentucky
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Louisville, Kentucky, United States, 40241
- Norton Cancer Institute, Audubon Hospital Campus
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Maryland
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Baltimore, Maryland, United States, 21287
- Johns Hopkins Hospital
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Massachusetts
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Boston, Massachusetts, United States, 02215
- Dana Farber Cancer Institute
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Michigan
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Detroit, Michigan, United States, 48202
- Henry Ford Health System
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Minnesota
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Minneapolis, Minnesota, United States, 55455
- University of Minnesota Medical Center-Fairview
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Rochester, Minnesota, United States, 55905
- Mayo Clinic
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Missouri
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St Louis, Missouri, United States, 63110
- Washington University School of Medicine - Siteman Cancer Center
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New Jersey
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New Brunswick, New Jersey, United States, 08901
- Rutgers Cancer Institute
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New York
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Buffalo, New York, United States, 43606
- Roswell Park Cancer Institute
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Lake Success, New York, United States, 11042
- The Monter Cancer Center
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New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center
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The Bronx, New York, United States, 10467
- Montefiore Medical Center-Montefiore Medical Park
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North Carolina
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Durham, North Carolina, United States, 27710
- Duke University Medical Center
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Ohio
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Columbus, Ohio, United States, 43210
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Solove Research Institute
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Toledo, Ohio, United States, 43606
- University of Toledo
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Oklahoma
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Oklahoma City, Oklahoma, United States, 73104
- Stephenson Cancer Center
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Oregon
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Portland, Oregon, United States, 97239
- Oregon Health & Science University Center for Health and Healing
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19111
- Fox Chase Cancer Center
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Tennessee
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Nashville, Tennessee, United States, 37232
- Henry-Joyce Cancer Clinic
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Texas
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Dallas, Texas, United States, 75246
- Texas Oncology-Baylor Charles A. Sammons Cancer Center
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Houston, Texas, United States, 77030
- University of Texas MD Anderson Cancer Center
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Virginia
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Richmond, Virginia, United States, 23298
- Virginia Commonwealth University Massey Cancer Center
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Washington
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Seattle, Washington, United States, 98195
- University of Washington Medical Center
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Wisconsin
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Milwaukee, Wisconsin, United States, 53226
- Froedtert Hospital-Medical College of Wisconsin
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients ≥ 18 years of age at the time of informed consent.
- Histologic diagnosis of GIST and must be able to provide an archival tumor tissue sample, otherwise, a fresh biopsy is required.
- Molecular pathology report must be available. If molecular pathology report is not available or insufficient, an archival tumor tissue sample or fresh biopsy is required for mutation status confirmation by the central laboratory prior to randomization.
- Patients must have progressed on imatinib or have documented intolerance to imatinib.
- Eastern Cooperative Oncology Group (ECOG) Performance Score (PS) of ≤ 2 at screening.
- Female patients of childbearing potential must have a negative serum beta-human chorionic gonadotropin (β-hCG) pregnancy test at screening and negative pregnancy test at Cycle 1 Day 1 prior to the first dose of study drug.
- Patients of reproductive potential must agree to follow the contraception requirements outlined in the study protocol.
- Patients must have at least 1 measurable lesion according to Modified Response Evaluation Criteria in Solid Tumors (mRECIST) Version 1.1 (non nodal lesions must be ≥ 1.0 cm in the long axis or ≥ double the slice thickness in the long axis) within 21 days prior to the first dose of study drug.
- Adequate organ function and bone marrow reserve as indicated by the central laboratory assessments performed at screening.
- Resolution of all toxicities from prior therapy to ≤ Grade 1 (or patient baseline) within 1 week prior to the first dose of study drug (excluding alopecia and ≤ Grade 3 clinically asymptomatic lipase, amylase, and creatine phosphokinase laboratory abnormalities).
- The patient is capable of understanding and complying with the protocol and the patient has signed the informed consent document. Signed informed consent form (ICF) must be obtained before any study-specific procedures are performed and the patient must agree to not participate in any other interventional clinical trial while on treatment in this clinical trial. Participation in a noninterventional study (including observational studies) is permitted.
Exclusion Criteria:
- Treatment with any other line of therapy in addition to imatinib for advanced GIST. Imatinib-containing combination therapy in the first-line setting is not allowed.
- Patients with a prior or concurrent malignancy whose natural history or treatment have the potential to interfere with the safety or efficacy assessment of this clinical trial are not eligible.
- Patient has known active central nervous system metastases.
- New York Heart Association class II-IV heart disease, myocardial infarction within 6 months of cycle 1 day 1, active ischemia or any other uncontrolled cardiac condition such as angina pectoris, clinically significant cardiac arrhythmia requiring therapy, uncontrolled hypertension or congestive heart failure.
- Left ventricular ejection fraction (LVEF) < 50% at screening.
- Arterial thrombotic or embolic events such as cerebrovascular accident (including ischemic attacks) or hemoptysis within 6 months before the first dose of study drug.
- Venous thrombotic events (e.g. deep vein thrombosis) or pulmonary arterial events (e.g. pulmonary embolism) within 1 month before the first dose of study drug. Patients on stable anticoagulation therapy for at least one month are eligible.
- 12-lead ECG demonstrating QT interval corrected (QTc) by Fridericia's formula > 450 ms in males or > 470 ms in females at screening or history of long QTc syndrome
- Use of known substrates or inhibitors of breast cancer resistance protein (BCRP) transporters within 14 days or 5 x the half-life (whichever is longer) prior to the first dose of study drug.
- Major surgeries (e.g. abdominal laparotomy) within 4 weeks of the first dose of study drug. All major surgical wounds must be healed and free of infection or dehiscence before the first dose of study drug.
- Any other clinically significant comorbidities.
- Known human immunodeficiency virus or hepatitis C infection only if the patient is taking medications that are excluded per protocol, active hepatitis B, or active hepatitis C infection.
- If female, the patient is pregnant or lactating.
- Known allergy or hypersensitivity to any component of the study drug.
Gastrointestinal abnormalities including but not limited to:
- inability to take oral medication
- malabsorption syndromes
- requirement for intravenous (IV) alimentation
- Any active bleeding excluding hemorrhoidal or gum bleeding.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Ripretinib
Ripretinib (150 mg) once a day continuous dosing for 6-week (42 days) cycles
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Oral KIT/PDGFRA kinase inhibitor
Other Names:
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Active Comparator: Sunitinib
Sunitinib (50 mg) once a day in 6-week (42 days) cycles with 4 weeks continuous dosing followed by 2 week break.
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Oral receptor tyrosine kinase (RTK) inhibitor
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Progression Free Survival (PFS) in the KIT Exon 11 Intent to Treat (ITT) Population
Time Frame: From date of randomization to earliest documented evidence of disease progression, or death due to any cause (up to 2.1 years)
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PFS is defined as the interval between the date of randomization and the earliest documented evidence of disease progression based on the independent radiologic review using modified RECIST Version 1.1-(mRECIST 1.1) GIST specific, or death due to any cause.
Per mRECIST 1.1, progression was defined using mRECIST 1.1 as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
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From date of randomization to earliest documented evidence of disease progression, or death due to any cause (up to 2.1 years)
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Progression Free Survival (PFS) in the All Patient (AP) Intent to Treat (ITT) Population
Time Frame: From date of randomization to earliest documented evidence of disease progression, or death due to any cause (up to 2.1 years)
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PFS is defined as the interval between the date of randomization and the earliest documented evidence of disease progression based on the independent radiologic review using modified RECIST Version 1.1-(mRECIST 1.1) Gastrointestinal stromal tumor (GIST) specific, or death due to any cause.
Per mRECIST 1.1, progression was defined using mRECIST 1.1 as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
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From date of randomization to earliest documented evidence of disease progression, or death due to any cause (up to 2.1 years)
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Objective Response Rate (ORR) in the KIT Exon 11 Intent to Treat (ITT) Population Population
Time Frame: From confirmed CR or PR to disease progression (up to 1.74 years)
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ORR was defined as the proportion of patients with confirmed complete response (CR) + confirmed partial response (PR) based on independent radiologic review using modified RECIST (mRECIST) criteria as best overall response.
Per mRECIST 1.1 criteria, complete response is defined as disappearance of all target lesions; partial response is defined as >=30% decrease in the sum of the longest diameter of target lesions.
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From confirmed CR or PR to disease progression (up to 1.74 years)
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Objective Response Rate (ORR) in the All Patient (AP) Intent to Treat (ITT) Population
Time Frame: From confirmed CR or PR to disease progression (up to 1.74 years)
|
ORR was defined as the proportion of patients with confirmed complete response (CR) + confirmed partial response (PR) based on independent radiologic review using modified RECIST (mRECIST) criteria as best overall response.
Per mRECIST 1.1 criteria, complete response is defined as disappearance of all target lesions; partial response is defined as >=30% decrease in the sum of the longest diameter of target lesions.
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From confirmed CR or PR to disease progression (up to 1.74 years)
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Overall Survival (OS) in the KIT Exon 11 Intent to Treat (ITT) Population
Time Frame: From date of randomization until death due to any cause (up to 3.33 years)
|
OS was defined as the time from the date of randomization until death due to any cause.
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From date of randomization until death due to any cause (up to 3.33 years)
|
|
Overall Survival (OS) in the All Patient (AP) Intent to Treat (ITT) Population
Time Frame: From date of randomization until death due to any cause (up to 3.33 years)
|
OS was defined as the time from the date of randomization until death due to any cause.
|
From date of randomization until death due to any cause (up to 3.33 years)
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Bauer S, Jones RL, Blay JY, Gelderblom H, George S, Schoffski P, von Mehren M, Zalcberg JR, Kang YK, Razak AA, Trent J, Attia S, Le Cesne A, Su Y, Meade J, Wang T, Sherman ML, Ruiz-Soto R, Heinrich MC. Ripretinib Versus Sunitinib in Patients With Advanced Gastrointestinal Stromal Tumor After Treatment With Imatinib (INTRIGUE): A Randomized, Open-Label, Phase III Trial. J Clin Oncol. 2022 Dec 1;40(34):3918-3928. doi: 10.1200/JCO.22.00294. Epub 2022 Aug 10.
- Nemunaitis J, Bauer S, Blay JY, Choucair K, Gelderblom H, George S, Schoffski P, Mehren MV, Zalcberg J, Achour H, Ruiz-Soto R, Heinrich MC. Intrigue: Phase III study of ripretinib versus sunitinib in advanced gastrointestinal stromal tumor after imatinib. Future Oncol. 2020 Jan;16(1):4251-4264. doi: 10.2217/fon-2019-0633. Epub 2019 Nov 22.
- Heinrich MC, Blay JY, Gelderblom H, George S, Schoffski P, von Mehren M, Zalcberg JR, Jones RL, Kang YK, Razak AA, Trent J, Attia S, Le Cesne A, Boye K, Goldstein D, Sanchez C, Siontis BL, Cox P, Davis E, Sherman ML, Ruiz-Soto R, Bauer S. Updated Overall Survival and Long-Term Safety With Ripretinib Versus Sunitinib in Patients With GI Stromal Tumor: Final Overall Survival Analysis From INTRIGUE. J Clin Oncol. 2025 Jul 10;43(20):2239-2244. doi: 10.1200/JCO-24-02818. Epub 2025 May 23.
- Heinrich MC, Jones RL, George S, Gelderblom H, Schoffski P, von Mehren M, Zalcberg JR, Kang YK, Razak AA, Trent J, Attia S, Le Cesne A, Siontis BL, Goldstein D, Boye K, Sanchez C, Steeghs N, Rutkowski P, Druta M, Serrano C, Somaiah N, Chi P, Reichmann W, Sprott K, Achour H, Sherman ML, Ruiz-Soto R, Blay JY, Bauer S. Ripretinib versus sunitinib in gastrointestinal stromal tumor: ctDNA biomarker analysis of the phase 3 INTRIGUE trial. Nat Med. 2024 Feb;30(2):498-506. doi: 10.1038/s41591-023-02734-5. Epub 2024 Jan 5.
- Gelderblom H, Jones RL, Blay JY, George S, von Mehren M, Zalcberg JR, Kang YK, Razak AA, Trent J, Attia S, Le Cesne A, Siontis BL, Goldstein D, Boye K, Sanchez C, Steeghs N, Rutkowski P, Druta M, Serrano C, Somaiah N, Chi P, Harrow B, Becker C, Reichmann W, Sherman ML, Ruiz-Soto R, Heinrich MC, Bauer S; INTRIGUE investigators. Patient-reported outcomes and tolerability in patients receiving ripretinib versus sunitinib after treatment with imatinib in INTRIGUE, a phase 3, open-label study. Eur J Cancer. 2023 Oct;192:113245. doi: 10.1016/j.ejca.2023.113245. Epub 2023 Jul 20.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms
- Neoplasms by Histologic Type
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Digestive System Diseases
- Gastrointestinal Diseases
- Neoplasms, Connective and Soft Tissue
- Neoplasms, Connective Tissue
- Gastrointestinal Stromal Tumors
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Heterocyclic Compounds, 2-Ring
- Heterocyclic Compounds, Fused-Ring
- Azoles
- Indoles
- Pyrroles
- Sunitinib
- ripretinib
Other Study ID Numbers
Other Study ID Numbers
- DCC-2618-03-002
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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