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Ripretinib for treating advanced gastrointestinal stromal tumours after 3 or more treatments

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1 Recommendations

1.1 Ripretinib is not recommended, within its marketing authorisation, for treating advanced gastrointestinal stromal tumour (GIST) in adults after 3 or more kinase inhibitors, including imatinib.

1.2 This recommendation is not intended to affect treatment with ripretinib that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.

Why the committee made these recommendations

Current treatment for advanced GIST, after people have tried the kinase inhibitors imatinib, sunitinib and regorafenib, is best supportive care.

Clinical trial evidence shows that ripretinib increases the time before the cancer gets worse and how long people live compared with best supportive care.

Ripretinib meets NICE's criteria to be considered a life-extending treatment at the end of life. But the economic model does not reflect clinical practice about when to stop treatment with ripretinib. This means it is not possible to work out if ripretinib is cost effective with the available analyses. So, it is not recommended.