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ESMO 2025 | Emerging therapies in GIST: IDRX-42, NB003, and bezuclastinib with sunitinib

Robin Jones, MBBS, MRCP, MD, Institute of Cancer Research, London, UK, gives an overview of new treatments for advanced and metastatic gastrointestinal stromal tumors (GISTs), including IDRX-42 and NB003. Additional drugs, such as ripretinib and avapritinib, have been approved in recent years, and ripretinib is being as a second-line treatment, with results from a trial expected to inform the use of ctDNA in metastatic GIST. Bezuclastinib plus sunitinib is also being assessed in the second-line setting. This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.

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Transcript

There are a number of drugs in development for the treatment of advanced and metastatic gastrointestinal stromal tumors or GISTs. These include IDRX-42, NB003, and these trials are currently undergoing evaluation in phase one trials. The number of drugs have been approved over the last few years, including ripretinib and avapritinib. Ripretinib is currently also being evaluated in a randomized phase three trial, a second-line treatment compared to sunitinib in patients with ctDNA-positive kit exon 11 as well as kit exon 17 and 18 mutations...

There are a number of drugs in development for the treatment of advanced and metastatic gastrointestinal stromal tumors or GISTs. These include IDRX-42, NB003, and these trials are currently undergoing evaluation in phase one trials. The number of drugs have been approved over the last few years, including ripretinib and avapritinib. Ripretinib is currently also being evaluated in a randomized phase three trial, a second-line treatment compared to sunitinib in patients with ctDNA-positive kit exon 11 as well as kit exon 17 and 18 mutations. That trial is close to completing recruitment and the results will be very informative in terms of the use of ctDNA in metastatic gastrointestinal stromal tumor. In addition, in the second line setting, a trial of bezocizumab plus sunitinib versus sunitinib alone has not been mentioned but rather a trial of bezocizumab’s analog, a drug with a similar name, has completed enrollment, however the actual drug mentioned was bezoclastinib. And again, that trial, we’re expecting the results over the next few months. And that will be very important in terms of the use of combination therapy in metastatic gastroenterostromal tumor, however the correct term is gastrointestinal. In addition, IDR42 and NB003 are going to be further evaluated in randomized trials.

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