Methods of treating gastrointestinal stromal tumors
The present disclosure relates to methods of treating gastrointestinal stromal tumors to a subject in need thereof, comprising administering to the subject a therapeutically effective amount of ripretinib or a pharmaceutically acceptable salt thereof.
1. A method of treating a patient suffering from an advanced gastrointestinal stromal tumor, and where the patient is being treated concurrently with a CYP3A4 inhibitor, comprising
orally administering to the patient a 150 mg daily dose of ripretinib, wherein the administration of the CYP3A4 inhibitor and the ripretinib to the patient increases ripretinib area under the plasma concentration curve (AUC 0-inf ) by 80% or more in the patient as compared to administration of ripretinib without concurrent treatment of the CYP3A4 inhibitor, and therefore the patient is at higher risk of an adverse event; and
monitoring the patient for the adverse event due to the ripretinib and CY3A4 inhibitor administration.
2. The method of claim 1 , wherein if the patient suffers from an adverse event upon administration of the ripretinib and the CY3A4 inhibitor, the method further comprises administering to the patient a reduced dose of 100 mg daily of the ripretinib.
3. The method of claim 1 , wherein if the patient suffers from a Grade 3 adverse event selected from the group consisting of arthralgia, myalgia and palmer-plantar erythrodysesthia syndrome after administration of the ripretinib and the CYP3A4 inhibitor, the method further comprises: a) withholding administration of the ripretinib for at least 7 days or until the patient has less than or equal to grade 1 of the adverse event, then b) administering to the patient 100 mg daily of the ripretinib for at least 28 days.
4. The method of claim 1 , wherein if the patient suffers from a Grade 3 adverse event after the administration of the ripretinib and the CYP3A4 inhibitor, the method further comprises: a) withholding administration of the ripretinib for at least 7 days or until the patient has less than or equal to grade 1 of the adverse event, then b) administering to the patient 100 mg daily of the ripretinib for at least 28 days.
5. The method of claim 1 , wherein the adverse event is one or more of: nausea, vomiting, anemia or abdominal pain.
6. The method of claim 1 , wherein the CYP3A4 inhibitor is selected from the group consisting of itraconazole, ketoconazole, clarithromycin, and indinavir.