%0 Journal Article %A Serrano, C. %A Bauer, S. %A Gómez-Peregrina, D. %A Kang, Y-K %A Jones, R. L. %A Rutkowski, P. %A Mir, O. %A Heinrich, M. C. %A Tap, W. D. %A Newberry, K. %A Grassian, A. %A Shi, H. %A Bialick, S. %A Schöffski, P. %A Pantaleo, M. A. %A von Mehren, M. %A Trent, J. C. %A George, S. %T Circulating tumor DNA analysis of the phase III VOYAGER trial: KIT mutational landscape and outcomes in patients with advanced gastrointestinal stromal tumor treated with avapritinib or regorafenib. %J Annals of oncology %V 34 %N 7 %@ 0923-7534 %C Amsterdam [u.a. %I Elsevier %M DKFZ-2023-00835 %P 615-625 %D 2023 %Z 2023 Jul;34(7):615-625 %X The current treatment paradigm of imatinib-resistant metastatic gastrointestinal stromal tumor (GIST) does not incorporate KIT/PDGFRA genotypes in therapeutic drug sequencing, except for PDGFRA exon 18-mutant GIST that are indicated for avapritinib treatment. Here, ctDNA sequencing was used to analyze plasma samples prospectively collected in the phase III VOYAGER trial to understand how the KIT/PDGFRA mutational landscape contributes to tyrosine-kinase inhibitor (TKI) resistance and to determine its clinical validity and utility.VOYAGER (N=476) compared avapritinib with regorafenib in patients with KIT/PDGFRA-mutant GIST previously treated with imatinib and 1 or 2 additional TKIs (NCT03465722). KIT/PDGFRA ctDNA mutation profiling of plasma samples at baseline and end-of-treatment was assessed with 74-gene Guardant360® CDx. Molecular subgroups were determined and correlated with outcomes.386/476 patients with KIT/PDGFRA-mutant tumors underwent baseline (pre-trial treatment) ctDNA analysis; 196 received avapritinib, and 190 received regorafenib. KIT and PDGFRA mutations were detected in 75.1 %K Avapritinib (Other) %K GIST (Other) %K KIT (Other) %K PDGFRA (Other) %K ctDNA (Other) %K regorafenib (Other) %F PUB:(DE-HGF)16 %9 Journal Article %$ pmid:37105265 %R 10.1016/j.annonc.2023.04.006 %U https://inrepo02.dkfz.de/record/275647