Where GIST treatment is heading
Gastrointestinal stromal tumor · Updated Nov 13, 2026
GIST is a rare sarcoma of the stomach or intestine, about 4,000 to 6,000 US cases a year, usually driven by a KIT or PDGFRA mutation. Imatinib controls it for years, but resistance mutations appear. A new wave of KIT drugs aims to cover more of them, starting in the second-line setting.
- 70studies open or running
- 6phase 3 trials
- 637papers published this year
- 1NIH-funded projects
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Now
Nov 2026
Longer imatinib after surgeryHappened 60% lower relapse risk
Six years instead of three cut relapse risk by 60% for high-risk tumors.
60%: lower risk of relapse with 6 years vs 3.
A blood test can steer the second drugHappened 14.2 mo with ripretinib
With exon 17/18 mutations, ripretinib held tumors 14.2 months vs 1.5 with sunitinib.
14.2 mo: before growth with ripretinib for KIT exon 11+17/18, vs 1.5 with sunitinib.
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6 months
by May 2027
FDA decision on bezuclastinib plus sunitinibLikely +7.3 mo before growth
Decision due November 30, 2026, after PEAK added 7.3 months before growth.
+7.3 mo: longer before growth: 16.5 vs 9.2 months.
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12 months
by Nov 2027
A new second-line standardPossible +7.3 mo before growth
If approved, bezuclastinib plus sunitinib would replace sunitinib alone after imatinib.
+7.3 mo: longer before growth: 16.5 vs 9.2 months.
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3 years
by late 2029
IDRX-42 against sunitinibPossible
GSK's 450-person phase 3 of a broad KIT blocker finishes May 2028.
NB003 after three drugsLong shot
A 255-person phase 3 tests NB003 against regorafenib, due August 2028.
-
5 years
by late 2031
Replacing imatinib first-lineLong shot
An 800-person GSK trial tests velzatinib against imatinib as first treatment; due 2032.
The research paths
Next-generation KIT blockers
+7.3 mo before growthDetails and 4 trialsHide
Drugs that block the resistance mutations imatinib misses.
WatchFDA decision; IDRX-42 and velzatinib phase 3s.
Combinations and blood tests
14.2 mo with ripretinibDetails and 1 trialsHide
Matching drugs to mutations seen in blood DNA, and pairing drugs to cover more mutations.
WatchKQB198 with imatinib.
Borrowed from other cancers
From Systemic mastocytosis
Bezuclastinib
Under FDA review
A KIT D816V blocker developed for a mast cell disease.
Open to join now
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After imatinib
IDRX-42 vs sunitinib
Locations and eligibility → -
First treatment
Velzatinib vs imatinib
Locations and eligibility → -
After 3 or more drugs
NB003 vs regorafenib
Locations and eligibility → -
Advanced GIST
KQB198 with imatinib
Locations and eligibility →
See every recruiting GIST trial →
When the trials finish
Completion dates the trials registered. Results usually follow 3 to 12 months later.
- Heating up
- Maturing
- Early
- Cooling
- Fully enrolled, waiting on results
- Still enrolling
Knowledge on the way
Not treatments yet: detection, causes and how care is delivered. Mostly NIH-funded.
- AreaQuestionFunded throughNews likely
- Biology Molecular mechanisms that drive GIST growthUniversity of Pennsylvania · NIH Funded through May 2027 News likely 2027–2028
What just happened
PEAK: 16.5 vs 9.2 months before growth
ASCO 2026.
Six years of imatinib beats three
IMADGIST, Annals of Oncology.
Standard treatment today
- Localized, after surgeryImatinib for 3 years if high risk; trials support longer.
- Advanced, first treatmentImatinib; avapritinib for PDGFRA D842V mutations.
- Second treatmentSunitinib; bezuclastinib plus sunitinib under FDA review.
- Later treatmentRegorafenib, then ripretinib.
How to read this page, and sourcesHow to read this page, and sources
- The FDA decision on bezuclastinib was pending as of this update.
- Forecasts are editorial judgments by Find a Trial, not predictions from sponsors or regulators.
See GIST trials recruiting now →