Ripretinib

Application submitted for manufacturing and marketing approval of ripretinib in Japan for the indication of “gastrointestinal stromal tumor that has progressed following cancer chemotherapy” Ripretinib has significantly prolonged the primary endpoint of progression-free survival compared to placebo in the INVICTUS study Already approved in the United States and Europe; recognized as a highly necessary medicine by the government review committee addressing drug loss in Japan Ono Pharmaceutical Co., Ltd. (Headquarters: Osaka, Japan; President: Toichi Takino; “Ono”) today announced that Ono submitted an application for the manufacturing and marketing approval of ripretinib (DCC-2618), developed by Deciphera Pharmaceuticals, Inc. (“Deciphera”), for the indication of “gastrointestinal stromal tumor that has progressed following cancer chemotherapy.” This application is based on the results of the INVICTUS study, a global Phase 3 clinical study, evaluating the efficacy of ripretinib compared to placebo in patients with advanced gastrointestinal stromal tumor (GIST) who have received prior treatment with 3 or more kinase inhibitors, including imatinib. In this study, ripretinib significantly prolonged the primary endpoint of progression-free survival (PFS) compared to placebo. “GIST is recognized as a rare disease worldwide, and ripretinib, developed by Deciphera, has already been approved in more than 40 countries and regions, including the United States and Europe. This application for approval of ripretinib represents a significant advancement for patients with GIST in Japan,” said Tatsuya Okamoto, Corporate Officer / Executive Director, Clinical Development of Ono. “Moving forward, we remain committed to developing and providing innovative medicines to meet the treatment needs of patients and the expectations of society.” “The application submission brings us one step closer to providing patients in Japan with advanced GIST a potential new treatment option. We anticipate that this submission may help address the issue of delayed access to new medicines, which remains a significant challenge for patients in Japan,” said Ryota Udagawa, President and Chief Executive Officer of Deciphera. “As GIST is a rare type of tumor, the limited availability of disease information and current treatment options are likely to cause significant anxiety for patients. Together with our group companies, we will continue to make every effort to deliver ripretinib to patients in Japan suffering from advanced GIST as quickly as possible.” The INVICTUS Phase 3 clinical study is a randomized, double-blind, placebo-controlled, international, multicenter study conducted in 12 overseas countries including US and EU to evaluate the safety, tolerability, and efficacy of ripretinib compared to placebo in 129 patients with advanced GIST who have received prior treatment with 3 or more kinase inhibitors, including imatinib. Patients were randomized 2:1 to either 150 mg of ripretinib or placebo once daily. In the INVICTUS study, ripretinib significantly prolonged the primary endpoint of PFS determined by independent central radiologic review (a median PFS of 6.3 months in ripretinib arm compared to 1.0 month in the placebo arm, HR of 0.15, p<0.0001). 1) GIST is a mesenchymal tumor that arises from the muscular layer of the gastrointestinal tract and forms a mass that pushes up the mucosa from below. GIST is a rare disease, with an incidence of approximately 1 to 2 cases per 100,000 population per year. In Japan, the number of patients diagnosed with GIST between 2016 and 2018 was 4,475 over three years (approximately 1,492 cases per year; crude incidence rate: 1.18 cases per 100,000 population). 2) It is known that mutations in KIT (KIT proto-oncogene receptor tyrosine kinase) and PDGFRα (platelet-derived growth factor receptor α) are involved in the development of the majority of patients with GIST. For unresectable, metastatic, or recurrent GIST, four agents—imatinib, sunitinib, regorafenib, and pimitespib—are currently approved in Japan. According to the Japanese clinical practice guidelines for GIST, these agents are recommended as first-line, second-line, third-line, and fourth-line treatments, respectively. 3) Ripretinib is an orally administered, tyrosine kinase inhibitor developed by Deciphera. Ripretinib inhibits primary and secondary KIT mutations in exons 9, 11, 13, 14, 17, and 18, which are involved in GIST. In addition, ripretinib inhibits primary PDGFRα mutations in exons 12, 14, and 18, including the exon 18 D842V mutation, which is present in a subset of GIST. The INVICTUS study has demonstrated the significant efficacy of ripretinib in patients with advanced GIST who have received prior treatment with 3 or more kinase inhibitors, including imatinib. Ripretinib was launched in the U.S. in 2020 under the brand name QINLOCK®. As of March 2026, it is approved for the treatment of advanced GIST in more than 40 countries or regions, including the U.S. and European countries. In Japan, ripretinib was designated as an orphan drug by the Ministry of Health, Labour and Welfare on March 19, 2026, for the treatment of GIST that have progressed following cancer chemotherapy. In addition, ripretinib was determined as a drug with high medical needs at the "67th Evaluation Committee on Unapproved or Off-label Drugs with High Medical Needs" held by Ministry of Health, Labour and Welfare, aiming to eliminate drug losses in Japan. Ono Pharmaceutical Co., Ltd. delivers innovative therapies for patients worldwide. Upholding its philosophy of “Dedicated to the Fight against Disease and Pain,” Ono targets areas with unmet medical needs including oncology, immunology & inflammation, and neurology, and fosters partnerships with academic and biotech organizations to accelerate drug discovery. Through its affiliate, Deciphera Pharmaceuticals, Ono is accelerating clinical development and commercial operations in the US and Europe to drive global business expansion and further its commitment to patient care. Deciphera, a member of Ono Pharmaceutical Co., Ltd., is a biopharmaceutical company focused on discovering, developing, and commercializing important new medicines and providing hope to people living with cancer, neurologic and autoimmune disease. Deciphera is leveraging its proprietary switch-control kinase inhibitor platform and deep expertise in kinase biology to develop a broad portfolio of innovative medicines. In addition to advancing multiple product candidates from Deciphera’s platform in clinical studies, QINLOCK® (ripretinib) is Deciphera’s switch-control kinase inhibitor approved in many countries including the European Union and the United States for the treatment of adult patients with advanced GIST who have received prior treatment with 3 or more kinase inhibitors, including imatinib. ROMVIMZA® is a kinase inhibitor approved in the United States for adult patients with symptomatic tenosynovial giant cell tumor (TGCT) for which surgical resection will potentially cause worsening functional limitation or severe morbidity, and in the European Union for adult patients with TGCT associated with clinically relevant physical function deterioration and in whom surgical options have been exhausted or would induce unacceptable morbidity or disability. References: 1) Blay JY, Serrano C, Heinrich MC, et al. Ripretinib in patients with advanced gastrointestinal stromal tumours (INVICTUS): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol. 2020;21:923-34. 2) -CANCER STATISTICS IN JAPAN-2025. Available from: 3) Japan Society of Clinical Oncology, ed. Japanese Clinical Practice Guidelines for Gastrointestinal Stromal Tumors (GIST), Fourth Edition, April 2022. KANEHARA & Co., Ltd. Available from: The content above comes from the network. if any infringement, please contact us to modify.

你有没有想过，面对癌症，医生手中到底有多少种‘武器’可以选择？ 国家卫健委办公厅在2026年1月19日印发了2025年版本的《新型抗肿瘤药物临床应用指导原则（2025年版）》[1]，于是我们做了这件事：把这四年的指南放在一起做了个比对[1-4]，结果发现了一些非常有意思的现象。一、我们先看最基础的页数，这直接反映了指南的体量。 从2022年的280页，到2023年的358页，再到2024年的439页，最终到2025年的605页。 在三年时间里，指南的厚度增长了一倍还多，累计净增了325页，涨幅116%！ 尤其值得注意的是2025年，这一版比上一个年度就多了166页，增加了37.8%，增幅惊人。二、显而易见，增加的内容首先是方案数大幅增加。 用药方案条目上从2022年的147条，跃升至2025年的261条。这意味着，可供医生参考的方案，在这三年里增加了近八成。 三、相应的，是药物数量的飞跃。 它从2022年的约103种，增长至2025年的约186种。三年增加了83种新药，临床医生手中的‘武器库’规模，在短短三年内累计增长80.6%。四、这一飞跃主要得益于多重动力的叠加： AI的发展加速了靶点发现与药物设计，同时，持续增加的研发投入、活跃的生物科技企业创新以及药政改革的深化，共同构成了强大的助推器，促进临床试验的数量与规模持续扩大，为新药研发提供了广阔平台。五、现在让我们更深入一步，把数据扒开再看看 这张图统计了从2022至2025年，各部位推荐用药条目数。其中有三个点最引人注目：首先是2025年新增了大量用药方案；其次是呼吸系统和血液系统的推荐药物条目数极为丰富，且在这几年连年大幅增加；第三是自2023年起，《原则》开始纳入泛实体瘤推荐药物。 另外值得注意的是，尽管绝大多数部位的药物种类数量呈现持续增长趋势，但个别系统在特定年份出现了净减少。如血液系统和骨与软组织肿瘤。而在这背后，其实是药物“有进有出”动态调整。一些药物是适用范围的变化，如斯鲁利单抗原本用于呼吸系统和消化系统，于2023年被纳入新增的“泛实体瘤“类中，随后又在2025年被移出此类。也有药物则因临床证据更新而被淘汰，如莫博赛替尼于2023年因III期EXCLAIM-2临床试验结果未达到主要研究终点退市。这种调整是目录更新的常态。六、更细致地来看，还可以发现以下变化： 首先，药物覆盖的靶点逐渐铺开，更加全面。新增的药物中有药物可以针对新的靶点，如针对KRAS G12C突变的格索雷塞，针对HIF-2α的贝组替凡，同时一些罕见突变的适用范围也覆盖到了更多种类的疾病。 其次，除开上述的罕见突变，针对一些常见突变或靶点的药物数量也大大增加。EGFR为靶点的药物进入“内卷时代”。在奥希替尼、阿美替尼、伏美替尼之后，新增了多个EGFR-TKI，如瑞齐替尼、利厄替尼等。众所周知，EGFR突变是肺癌中的常见突变类型，现在回头来看，这正好对应上了呼吸系统用药数大大增加。另一个显著扩容的是靶向PD-1/PD-L1的药物：从2022年的13种增加至2025年的22种，且大量药物在此期间增加了适用范围。同时国产PD-1/PD-L1全面崛起，涌现出如阿得贝利、普特利、赛帕利等药物，临床选择更加多元化。 另外，还有一个非常的显著的变化，那就是ADC类药物和CAR-T类药物迅猛发展，大量新药涌现。从2022年的4种增长至2025年的11种不同ADC药物。尤其是2025年，ADC类药物新增了7条推荐。适应症范围从乳腺、消化、泌尿、血液扩展到呼吸、生殖，几乎覆盖所有主要实体瘤。而其中，明星药物德曲妥珠单抗在三年内从乳腺癌迅速扩展至消化、呼吸，成为跨癌种ADC典范。在这几年里，ADC的靶点从HER2到Trop-2、nectin-4、FRα，越来越丰富，为患者提供更多治疗选择。国产ADC在其中快速跟进，形成进口与国产并存的格局。CAR-T类药物则是在2023年实现了“零的突破”，从这一年开始《指导原则》中有了CAR-T药物，分别是伊基奥仑赛，阿基仑赛，瑞基奥仑赛，均用于治疗血液肿瘤。至2025年时，扩展到了5种，且同时包含国产和进口药物。标志着这种高度个性化、一次性治疗的创新疗法在中国获得正式临床地位。七、这一切对肿瘤患者而言，是根本性的重大利好： 首先，最直接的体现是可选药物的急剧增加，这意味着每位患者找到有效治疗方案的概率大大提升。 药物基数的扩大，使临床医生在制定个性化方案时，可调配的“武器”更多了。这种丰富性直接推动了第二个利好：药物联用方案的增多。 因为当药物的基数增加时，理论上可形成的组合方案会呈几何级数增长，这为攻克耐药、提升疗效提供了更强大的“组合拳”。 这些将直接影响到患者的治疗效果。正如我们所见到的，呼吸系统的可用药物数正在惊人地增长，而肺癌患者的生存期也得以大大延长。一份专家共识指出，第三代EGFR-TKI的陆续问世，让晚期EGFR突变肺癌患者的5年总生存率从之前的14.6%提升至28%，翻了近一番[5]。 而这些新药、新组合要真正落地，离不开第三个直接利好：患者能参与的临床试验也大大增加了。对很多患者来说，这不仅是费用减免的机会，也是用到前沿疗法、获得新希望的重要途径。八、不过，这个变化也许会让医生的工作更难。 因为问题不再是“有无药可用”，而是在同一适应症下，从多种机制、不同代际的药物中作出选择，这需要在疗效、毒副、耐药、费用乃至患者意愿之间反复权衡。在这个药物、技术爆炸般更新迭代的时代，医生们不仅要在医院里不断积攒临床经验，更要在幕后不断汲取新的知识。 肿瘤的高度异质性更意味着没有“万能药”，现在医生可以借助基因检测这些手段，再加上不断更新的知识，从这么多选项里，帮患者找到更合适的方案。 而在这一片信息的汪洋大海面前，AI将展现出无可比拟的优势，未来的医疗，必将进入AI时代。九、这就又关系到了最近非常火热的话题，AI能否取代医生？ 而在这一系列讨论后，我们的观点却非常反直觉：医生的角色反而更加不可替代。 首先就是老生常谈的，医生的经验，是在真实的、复杂的世界中积攒的，是AI的数据库所不具有的，也不是当前的AI可用通过推理能准确判断的。从统计学的角度来说，医生积累的“先验”的质量，是治疗的关键。不过这也意味着将来对“好医生”的需求会更高，但要求也会更严苛。 另外，也是很重要的一点，治疗不是数据运算。它关乎人。患者经济条件如何？他本人意愿是什么？是追求最长的生存期，还是生活质量？ 在事关生死的选择面前，怎样安抚病人的情绪？当患者意识到在命运的路口出现更多岔路供选择时，医生又该如何安抚患者选择的焦虑，给予患者勇敢走下去的信心？这些充满人情味的关怀和权衡，恰恰是AI的死角。AI无法像人类一样思考生老病死，生命的温度，最后还是需要人来提供。 肿瘤治疗正从“缺药可用”进入“AI辅助，择优而用”的时代。 对于这场变革，你怎么看待？欢迎在评论区聊聊你的观察。 参考文献： [1]https://www.nhc.gov.cn/yzygj/c100068/202212/fd6148a5383246b1851dff937507bcb9.shtml [2]https://www.nhc.gov.cn/yzygj/c100068/202401/1d26e5c2254b4930ab6056f942ca9dbf.shtml [3]https://www.nhc.gov.cn/yzygj/c100068/202501/4b86cb63eb03400eb789f371316ecea1.shtml [4]https://www.nhc.gov.cn/yzygj/c100067/202601/460c2377aa294b55baacd339b8b19eb8.shtml [5] Chang GC, Kapoor A, Lee CK, et al. Optimizing management of stage IV EGFR mutant non-small cell lung cancer in Asia: An expert opinion. Int J Cancer. 2025;157(8):1648-1661. doi:10.1002/ijc.35512 各年份药物变化情况表 2022年药物（基准） 2023年变化（相比2022年） 2024年变化（相比2023年） 2025年变化（相比2024年） 呼吸系统 吉非替尼、厄洛替尼、埃克替尼、阿法替尼、达可替尼、奥希替尼、阿美替尼、伏美替尼、克唑替尼、阿来替尼、塞瑞替尼、恩沙替尼、布格替尼、洛拉替尼、贝伐珠单抗、重组人血管内皮抑制素、安罗替尼、依维莫司、普拉替尼、赛沃替尼、达拉非尼、曲美替尼、恩曲替尼、纳武利尤单抗、帕博利珠单抗、度伐利尤单抗、阿替利珠单抗、卡瑞利珠单抗、替雷利珠单抗、信迪利单抗、伊匹木单抗、舒格利单抗 新增：贝福替尼、伊鲁阿克、塞普替尼、谷美替尼、莫博赛替尼、特瑞普利单抗、斯鲁利单抗、派安普利单抗、阿得贝利单抗 新增：瑞齐替尼、瑞厄替尼、舒沃替尼、依奉阿克、伯瑞替尼、特泊替尼、卡马替尼、安奈克替尼、瑞普替尼、贝莫苏拜单抗、依沃西单抗 新增：利厄替尼、佐利替尼、他雷替尼、氟泽雷塞、格索雷塞、戈来雷塞、德曲妥珠单抗、瑞康曲妥珠单抗、埃万妥单抗、芦康沙妥珠单抗、芦比替定 删除：无 删除：莫博赛替尼 删除：无 消化系统 索拉非尼、瑞戈非尼、仑伐替尼、多纳非尼、阿替利珠单抗、信迪利单抗、卡瑞利珠单抗、替雷利珠单抗、帕博利珠单抗、特瑞普利单抗、曲妥珠单抗、阿帕替尼、纳武利尤单抗、维迪西妥单抗、雷莫西尤单抗、伊马替尼、舒尼替尼、阿伐替尼、瑞派替尼、依维莫司、索凡替尼、贝伐珠单抗、西妥昔单抗、呋喹替尼、恩沃利单抗、斯鲁利单抗、拉罗替尼、佩米替尼 新增：普特利单抗、尼妥珠单抗 新增：德曲妥珠单抗、舒格利单抗、卡度尼利单抗、度伐利尤单抗 新增：伊匹木单抗、佐妥昔单抗、西妥昔单抗β、恩考芬尼、泽尼达妥单抗 删除：拉罗替尼 删除：无 删除：无 血液 伊马替尼、达沙替尼、尼洛替尼、奥雷巴替尼、氟马替尼、伊布替尼、泽布替尼、奥布替尼、硼替佐米、卡非佐米、伊沙佐米、沙利度胺、来那度胺、泊马度胺、达雷妥尤单抗、塞利尼索、吉瑞替尼、维奈克拉、艾伏尼布、贝林妥欧单抗、信迪利单抗、卡瑞利珠单抗、替雷利珠单抗、派安普利单抗、利妥昔单抗、奥妥珠单抗、维布妥昔单抗、西达本胺、芦可替尼 新增：赛帕利单抗、瑞帕妥单抗、泽贝妥单抗、维泊妥珠单抗、奥加伊妥珠单抗、林普利塞、度维利塞、莫格利珠单抗、司妥昔单抗、伊基奥仑赛、阿基仑赛、瑞基奥仑赛 新增：特立妥单抗、戈利昔替尼、泽沃基奥仑赛、格菲妥单抗、罗培干扰素α-2b 新增：泊那替尼、阿思尼布、阿可替尼、匹妥布替尼、艾沙妥昔单抗、塔奎妥单抗、埃纳妥单抗、坦昔妥单抗、吉卡昔替尼、他泽司他、纳基奥仑赛、莫妥珠单抗、埃普奈明 删除：无 删除：无 删除：无 泌尿系统 索拉非尼、舒尼替尼、培唑帕尼、阿昔替尼、依维莫司、替雷利珠单抗、特瑞普利单抗、维迪西妥单抗、阿比特龙、阿帕他胺、恩扎卢胺、达罗他胺、瑞维鲁胺、奥拉帕利、仑伐替尼、纳武利尤单抗、帕博利珠单抗 无 新增：伏罗尼布 新增：他拉唑帕利、维恩妥尤单抗、安罗替尼、贝莫苏拜单抗、贝组替凡、厄达替尼 删除：无 删除：无 乳腺癌 曲妥珠单抗、恩美曲妥珠单抗、帕妥珠单抗、伊尼妥单抗、拉帕替尼、吡咯替尼、奈拉替尼、哌柏西利、阿贝西利、西达本胺、达尔西利、依维莫司、戈沙妥珠单抗 新增：德曲妥珠单抗、瑞波西利、帕博利珠单抗 新增：帕妥珠曲妥珠单抗（皮下注射）、特瑞普利单抗、恩替司他 新增：维迪西妥单抗、芦康沙妥珠单抗、吡洛西利、伏维西利、来罗西利、泰瑞西利、伊那利塞、卡匹色替、阿帕替尼、氟唑帕利、奥拉帕利 删除：无 删除：无 删除：无 皮肤 维莫非尼、达拉非尼、曲美替尼、帕博利珠单抗、特瑞普利单抗、索立德吉、伊马替尼 新增：普特利单抗 新增：妥拉美替尼 新增：无 删除：无 删除：无 删除：伊马替尼 骨与软组织 依维莫司、地舒单抗、安罗替尼、拉罗替尼 新增：无 新增：他泽司他 新增：无 删除：拉罗替尼 删除：无 删除：他泽司他 头颈部 尼妥珠单抗、特瑞普利单抗、卡瑞利珠单抗、索拉非尼、仑伐替尼、安罗替尼、纳武利尤单抗、西妥昔单抗、帕博利珠单抗、替雷利珠单抗、普拉替尼 无 新增：塞普替尼 新增：菲诺利单抗 删除：无 删除：无 生殖系统 奥拉帕利、尼拉帕利、氟唑帕利、帕米帕利、贝伐珠单抗、卡度尼利单抗 无 新增：索卡佐利单抗、赛帕利单抗 新增：塞纳帕利、苏维西塔单抗、法米替尼、安罗替尼、恩朗苏拜单抗、艾帕洛利托沃瑞利单抗、帕博利珠单抗、卡瑞利珠单抗、贝莫苏拜单抗、索米妥昔单抗 删除：无 删除：无 泛实体瘤 无 新增：拉罗替尼、恩曲替尼、恩沃利单抗、替雷利珠单抗、斯鲁利单抗、普特利单抗 新增：帕博利珠单抗 新增：无 删除：无 删除：无