Gastrointestinal Stromal Tumor (GIST) Insights and Trends

• GISTs can develop anywhere along the gastrointestinal tract, from the esophagus to the anus. The stomach accounts for approximately 55% of cases, making it the most common site of origin, followed by the duodenum and small intestine (30%). Less frequently, GISTs arise in the esophagus (5%), rectum (5%), and colon (2%). In rare cases, primary GISTs may develop outside the gastrointestinal tract, including the peritoneum, mesentery, omentum, liver, pancreas, ovaries, uterus, and prostate.

• GISTs comprise less than 1% of all gastrointestinal tumors but are the most common mesenchymal tumors of the gastrointestinal tract.  

• GIST are classified by their risk of recurrence or progression rather than as benign or malignant. Risk assessment is based on tumor size, mitotic index, location, and mutation status. Molecular testing for Receptor Tyrosine Kinase (KIT) or Platelet-Derived Growth Factor Receptor Alpha (PDGFRA) mutations is recommended, with SDH (succinate dehydrogenase) testing performed in tumors that are negative for both mutations.

• GIST typically presents in the gastrointestinal tract with 80% of cases driven by mutations in the KIT gene that lead to the growth, proliferation and survival of tumour cells. Around 12–15% of cases lack detectable mutations in both genes and are classified as KIT/PDGFRA wild-type (WT) GISTs. Additionally, <5% of GISTs are associated with hereditary or syndromic conditions, including neurofibromatosis type 1 (NF1), Carney triad syndrome, and other familial disorders.

• GISTs can affect patients of all ages but are most predominant in older adults (median age, 65–69 years).

• A substantial proportion of GIST patients present with advanced disease, with up to 50% exhibiting metastases or multifocal tumor involvement at diagnosis. 

• Historically, GIST management relied mainly on surgical resection, with chemotherapy showing limited efficacy in advanced disease. Next-generation therapies such as ripretinib (QINLOCK) and Avapritinib (AYVAKIT) address resistance mutations and improve later-line disease control. 

• About 15–20% of GISTs have primary resistance; they don’t respond to these drugs, right from the start of treatment. The Tyrosine kinase inhibitors (TKIs) approved for GIST include; imatinib (GLEEVEC) (1st line), sunitinib (SUTENT) (2nd line), regorafenib (STIVARGA) (3rd line), and ripretinib (QINLOCK) (4th line).

• Approved therapies for GIST includes companies such as ONO Pharmaceutical (ripretinib), Blueprint Medicines Corporation, Sanofi (avapritinib), Bayer (larotrectinib), and others.

• Pharmaceutical companies developing therapies for GIST include: Cogent Biosciences (Bezuclastinib), GSK (Velzatinib), Sartar Therapeutics (SAR003), Kumquat Biosciences (KQB198) and others.

Gastrointestinal Stromal Tumor (GIST) Market Size and Forecast in the 7MM

• 2025 GIST Market Size: ~USD XX million

• 2036 Projected GIST Market Size: ~USD XX million

• GIST Growth Rate (2026–2036): XX% CAGR

DelveInsight's ‘Gastrointestinal Stromal Tumor (GIST) Market Insights, Epidemiology and Market Forecast – 2036’ report delivers an in-depth understanding of the GIST, historical and forecasted epidemiology, as well as the GIST market trends in the United States, EU4 (Germany, Spain, Italy, and France) and the United Kingdom, and Japan.

The Gastrointestinal Stromal Tumor (GIST) market report delivers a comprehensive analysis of the current treatment landscape, including standards of care, clinical practices, and evolving therapeutic algorithms. It evaluates, GIST patient burden trends, revenue & market share dynamics, peak patient share & therapy uptake analysis, and provides an in-depth market size assessment, and growth rate projections (Historical & Forecast 2022–2036) across global regions. The report highlights key unmet medical needs in GIST and maps the competitive and clinical landscape to uncover high‑value opportunities, providing a clear outlook on future market growth potential.

Key Factors Driving the Gastrointestinal Stromal Tumor (GIST) Market

Rising Incidence and Improved Diagnosis

Increasing awareness and better diagnostic techniques, including molecular testing for KIT and PDGFRA mutations, are leading to earlier and more accurate detection of GIST. This expands the treatable patient population. Improved pathology practices are also reducing misdiagnosis rates.

Advancements in Targeted Therapies

The shift from conventional chemotherapy to targeted TKIs has transformed GIST treatment outcomes. Newer agents with improved mutation specificity and resistance coverage are further driving market growth. Ongoing innovation continues to expand therapeutic options.

Favorable Regulatory Support

Orphan drug designations, fast track approvals, and priority review pathways are expediting development timelines. Regulatory incentives encourage innovation in rare cancers like GIST. This reduces barriers for market entry.

Gastrointestinal Stromal Tumor (GIST) Understanding 

Gastrointestinal Stromal Tumor (GIST) Overview 

GIST is a rare type of mesenchymal tumor of the gastrointestinal tract, most commonly arising in the stomach or small intestine. It is primarily driven by activating mutations in the KIT or PDGFRA genes, which lead to uncontrolled cell growth. Despite its rarity, reported incidence has increased in recent years due to improved diagnostic techniques and wider use of molecular testing.

Diagnosis typically involves a combination of imaging, histopathology, and molecular testing. Techniques such as CT scans and endoscopy help identify tumor location and size, while a biopsy confirms the diagnosis. Immunohistochemical markers like KIT (CD117) and DOG1 are commonly used to distinguish GIST from other tumors. Genetic testing is essential to identify KIT or PDGFRA mutations, as this directly guides treatment decisions and therapy selection.

Further details are provided in the report.

Current Gastrointestinal Stromal Tumor (GIST) Treatment Landscape

Treatment depends on tumor size, location, mutation type, and stage of disease. Surgical resection remains the primary approach for localized GIST, while targeted therapies are the mainstay for advanced or metastatic cases. TKIs have significantly improved outcomes by specifically targeting oncogenic drivers. Key approved therapies include ripretinib, which is used in later-line settings for advanced GIST. Avapritinib is specifically effective in patients with PDGFRA exon 18 mutations, including the difficult-to-treat D842V mutation.

Further details related to country-based variations are provided in the report.

Gastrointestinal Stromal Tumor (GIST) Unmet Needs

The section “unmet needs of Gastrointestinal Stromal Tumor (GIST)” outlines the critical gaps between the current state of patient care, diagnosis, and the ideal & effective management of the disease. It highlights the obstacles experienced by patients, clinicians, and researchers and identifies potential solutions for future progress. 

1. Development of treatment resistance to existing targeted therapies

2. Emergence of drug-resistant tumor subclones and molecular heterogeneity 

3. Limited treatment options for wild-type and SDH-deficient GIST

4. Challenges in long-term survivorship and disease monitoring, and others…..

Note: Comprehensive unmet needs insights in GIST and their strategic implications are provided in the full report.

Gastrointestinal Stromal Tumor (GIST) Epidemiology

Key Findings from GIST Epidemiological Analysis and Forecast 

• In 2025, the US accounted for the highest incident cases of GIST with more than 5,600 cases. These cases are anticipated to increase during the forecast period. 

• The number of new cases of GISTs in the United States each year has been estimated at 5,000–6,000.  

•  GISTs constitute 0.1–3% of all GI neoplasms. The estimated annual incidence is 10–15 new cases per million people or approximately 3,000–5,000 new cases in the US yearly. Although GISTs may occur at all ages, the peak incidence is in the sixth decade of life, with a slight male predominance.

• In the United States, GISTs most commonly arise in the stomach (~60%) and small intestine (~35%), while a smaller proportion occur in the esophagus, colon, rectum, or, rarely, outside the gastrointestinal tract within the abdominal cavity. 

• GIST is more common among males than females.

• GIST is more commonly diagnosed at the localized stage compared to other stages.

Gastrointestinal Stromal Tumor (GIST) Drug Analysis & Competitive Landscape

The GIST drug chapter provides a detailed, market-focused review of approved therapies and the emerging pipeline across Preclinical and Phase III clinical trials. It covers mechanism of action, clinical trial data, regulatory approvals, patents, collaborations, strategic partnerships upcoming Key catalyst for each therapy, along with their advantages, limitations, and recent developments. This section offers critical insights into the GIST treatment landscape, supporting market assessment, competitive analysis, and growth forecasting for the GIST therapeutics market.

Approved Therapies for Gastrointestinal Stromal Tumor (GIST)

Ripretinib (QINLOCK): ONO Pharmaceutical

Ripretinib (QINLOCK) is an oral switch-control TKI designed to treat GIST, targeting a broad range of KIT and PDGFRA mutations, including initiating and resistance mutations in exons 9, 11, 13, 14, 17, and 18. Beyond its approved use, it is also under Phase III (INSIGHTS) investigation as a second-line therapy, underscoring its potential to expand treatment options and address resistance challenges in GIST. QINMOCK was designated an orphan medicine in October 2017 by the EMA. The US FDA granted Fast Track Designation (FTD) and Orphan Drug Designation (ODD) for advanced GIST treatment after prior therapies. ONO Pharmaceutical, acquired Deciphera in April 2024. As per ONO pharma financial results 2025–26, sales of ripretinib for GIST increased by USD 80 million (50.6%) year on year to USD 239.5 million. 

Avapritinib (AYVAKIT): Sanofi (Blueprint Medicines Corporation)

Avapritinib (AYVAKIT) is a selective kinase inhibitor approved for adults with unresectable or metastatic GIST harboring PDGFRA exon 18 mutations, including D842V, and Advanced Systemic Mastocytosis (AdvSM). The US FDA granted AYVAKIT ODD, Breakthrough Therapy Designation (BTD), and FTD for GIST. Approved in January 2020 for PDGFRA D842V-mutant GIST, it also received EU marketing authorization in September 2020 and orphan medicine designation from the EC in July 2017.

Note: Detailed marketed therapies assessment will be provided in the final report.

Gastrointestinal Stromal Tumor (GIST) Pipeline Analysis

Bezuclastinib: Cogent Biosciences

Bezuclastinib, developed by Cogent Biosciences, is a selective type I tyrosine kinase inhibitor targeting KIT activation loop mutations, particularly KIT D816V. It is the  first positive 2nd -line GIST trial in over 20 year. The NDA for bezuclastinib in combination with sunitinib was accepted under Priority Review, with a PDUFA target action date of November 30, 2026. Cogent also plans to present detailed results from the PEAK trial at an upcoming scientific conference in the first half of 2026. Bezuclastinib received ODD from the US FDA in 2021. With a global annual market opportunity of over USD 4 billion, the therapy became the first to report positive second-line GIST trial results in more than two decades, reducing the risk of progression or death by 50%.

Velzatinib (IDRX-42/GSK6042981): GSK

IDRX-42 is a highly selective, investigational small molecule TKI designed to target all key KIT mutations in GIST. The US FDA has granted IDRX-42 FTD for the treatment of patients with GIST after disease progression on or intolerance to imatinib, and ODD for the treatment of GIST. According to the company’s annual report 2025, GSK is aiming to initiate the first-line (1L) phase III study in 2026. Velzatinib has demonstrated activity pre-clinically against all clinically relevant primary and secondary KIT mutations, a key medical need in current GIST treatment.

Note: Detailed emerging therapies assessment will be provided in the final report.

Gastrointestinal Stromal Tumor (GIST) Key Players, Market Leaders and Emerging Companies

• Eli lily and company

• Sanofi

• ONO Pharmaceutical

• Blueprint Medicines Corporation

• Bayer

• Loxo Oncology

• Cogent Biosciences

• GSK

• Sartar Therapeutics, and others

Gastrointestinal Stromal Tumor (GIST) Drug Updates

• In May 2026,  Cogent Biosciences announced detailed clinical data from the primary analysis of the PEAK Phase III trial of bezuclastinib in combination with sunitinib in patients GIST. The data demonstrate statistically significant advantage against active comparator in GIST patients; median PFS of 16.5 months versus 9.2 months for bezuclastinib combination compared to sunitinib alone.

• In January 2026, Cogent Biosciences announced that the US FDA has granted Breakthrough Therapy Designation (BTD) for bezuclastinib in combination with sunitinib for patients with GIST who have received prior treatment with imatinib. 

• In November 2025, Cogent Biosciences reported positive data from its Phase III PEAK trial of bezuclastinib plus sunitinib in patients with imatinib-resistant or intolerant GIST. The results showed 50% reduction in risk of progression or death, with a 16.5-month median PFS.

• In September 2025, Sartar Therapeutics received ODD for SAR003 for GIST from both the EMA and FDA.

• In July 2025, Sanofi announced the completion of its acquisition of Blueprint Medicines Corporation.

• In May 2025, the results of ripretinib versus sunitinib in patients with GIST were published in ASCO publications. The results showed that OS from the analysis was similar between arms, and second PFS suggests that receiving ripretinib did not adversely affect the PFS of third-line therapy.

Gastrointestinal Stromal Tumor (GIST) Market Outlook

The GIST market is undergoing a steady transformation, with years of reliance on surgery and a limited number of systemic therapies, primarily TKIs. Surgical resection remains the cornerstone for localized disease. Recent advances in precision oncology, particularly improved understanding of KIT and PDGFRA mutation heterogeneity, have begun to reshape the treatment landscape by enabling more targeted and mutation-specific therapeutic approaches.

This shift is reflected in the development and approval of next-generation agents such as Ripretinib (QINLOCK), which provides broad-spectrum inhibition across multiple KIT and PDGFRA mutations and is used in later-line settings, and Avapritinib (AYVAKIT), specifically designed for PDGFRA exon 18 mutations, including the resistant D842V variant. Additionally, Larotrectinib (VITRAKVI), represents a tumor-agnostic targeted therapy for cancers harboring NTRK gene fusions, including rare cases of GIST. Together, these therapies highlight the transition toward precision-based treatment.

The pipeline of investigational agents is advancing through clinical development, reflecting continued innovation in GIST treatment. Key candidates include Bezuclastinib (CGT9486), a selective KIT inhibitor targeting activation loop mutations; IDRX-42 (GSK6042981), a broad-spectrum pan-KIT inhibitor designed to address both primary and resistance mutations, and SAR003, an emerging investigational therapy with potential activity in KIT-driven tumors. These pipeline agents, along with ongoing research into combination strategies and next-generation inhibitors, aim to overcome resistance mechanisms, improve the durability of response, and expand treatment options.

• The GIST treatment landscape is largely dominated by TKI, supported by strong adoption in both advanced and mutation-specific disease settings.

• The entry of late-stage candidates such as Bezuclastinib (CGT9486) and Velzatinib (IDRX-42) is expected to intensify competition in the GIST treatment landscape during the latter half of the forecast period.

Further details will be provided in the report….

Drug Class/Insights into Leading Emerging and Marketed Therapies in GIST (2022–2036 Forecast)

The GIST market comprises TKI and TRK inhibitors, each targeting different aspects of GIST.

• TKI: TKIs constitute the dominant therapeutic class in GIST, targeting oncogenic kinases that drive tumor growth and survival. Approved agents such as ripretinib and avapritinib inhibit KIT and/or PDGFRA signaling, while emerging therapies including bezuclastinib, velzatinib, and SAR003 are designed to provide broader inhibition of primary and secondary KIT resistance mutations.

• TRK: Larotrectinib represents a distinct targeted therapy class that selectively inhibits TRK fusion proteins. Although NTRK fusions are uncommon in GIST, TRK inhibitors offer a precision medicine approach for patients harboring these actionable genomic alterations.

Since many of the drugs are KIT/PDGFRA-directed TKIs, the key drug class driving the GIST market is Tyrosine Kinase Inhibitors (TKIs).

Gastrointestinal Stromal Tumor (GIST) Drug Uptake

This section focuses on the uptake rate of potential drugs expected to be launched in the market during the forecast period (2026–2036). The analysis covers the GIST drug’s uptake, performance at peak, factors affecting performance during prime years of growth, patient uptake by therapy, and anticipated sales generated by each drug.

The uptake of therapies in GIST is expected to vary based on clinical positioning, mechanism of action, and stage of development. Approved targeted therapy such as ripretinib (QINLOCK) is projected to demonstrate relatively faster uptake, driven switch-control tyrosine kinase inhibition of KIT and PDGFRA, along with broad activity across primary and secondary resistance mutations. In contrast, pipeline candidate bezuclastinib (CGT9486) is expected to follow a moderate uptake trajectory, reflecting its investigational status and gradual adoption as clinical evidence emerges. Meanwhile, SAR003 is anticipated to show gradual uptake, as it is in the preclinical development stage.

Detailed insights of emerging therapies' drug uptake is included in the report

Market Access and Reimbursement of Approved therapies in Gastrointestinal Stromal Tumor (GIST)

Reimbursement is a crucial factor that affects the drug’s access to the market. Often, the decision to reimburse comes down to the price of the drug relative to the benefit it produces in treated patients. To reduce the healthcare burden of these high-cost therapies, many payment models are being considered by payers and other industry insiders.

The United States

The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc. 

NOTE: Further Details are provided in the final report….

Gastrointestinal Stromal Tumor (GIST) Therapies Price Scenario & Trends

Pricing and analogue assessment of GIST therapies highlights evolving price dynamics structures. This section summarizes the cost of approved treatments, closest and most appropriate analogue selection for emerging therapies, and understanding of how pricing influences market access, adherence, and long-term uptake.

Industry Experts and Physician Views for Gastrointestinal Stromal Tumor (GIST)

To keep up with GIST market trends, we take Key Opinion Leaders (KOLs) and Subject Matter Experts (SMEs) opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry experts were contacted for insights on the GIST emerging therapies, evolving treatment landscape, patient adherence to conventional therapies, therapy switching trends, drug adoption and uptake, accessibility challenges, and epidemiology and real-world prescription patterns in GIST, including MD, PhD, Instructor, Postdoctoral Researcher, Professor, Researcher, and others.

DelveInsight’s analysts connected with 15+ KOLs to gather insights at country level. Centers such as the Michigan State University, Birmingham University Hospitals, Fujita Health University, etc. were contacted.Their opinion helps understand and validate current and emerging GIST therapies, highlight unmet medical needs, provide epidemiological context, and support strategic decisions for market access, therapy adoption, and pipeline prioritization in GIST.

Qualitative Analysis: SWOT and Conjoint Analysis

We perform qualitative and market Intelligence analysis using various approaches, such as SWOT analysis and conjoint analysis. 

In the SWOT analysis of GIST, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided.

Conjoint analysis analyzes emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry. Scoring is given based on these parameters to analyze the effectiveness of therapy.

The team of analysts analyzes promising emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry. In efficacy, the trial’s primary and secondary outcome measures are evaluated, whereas the therapies’ safety is evaluated, wherein the acceptability, tolerability, and adverse events are majorly observed. In addition, the scoring is also based on the route of administration, order of entry, probability of success, and the addressable patient pool for each therapy. According to these parameters, the final weightage score and the ranking of the emerging therapies are decided.

Scope of the Report

• The report covers a segment of key events, an executive summary, a descriptive overview of GIST, explaining their causes, signs and symptoms, pathogenesis, and currently available treatments.

• Comprehensive insight has been provided into the epidemiology segments and forecasts, the future growth potential of the diagnosis rate, and disease progression along treatment guidelines.

• Additionally, an all-inclusive account of both the current and emerging treatments, along with the elaborative profiles of late-stage and prominent therapies, will have an impact on the current treatment landscape.

• A detailed review of the GIST market, historical and forecasted market size, market share by therapies, detailed assumptions, and rationale behind our approach is included in the report, covering the 7MM drug outreach.

• The report provides an edge while developing business strategies by understanding trends through SWOT analysis and expert insights/KOL views, patient journey, and treatment preferences that help in shaping and driving the 7MM GIST market.

Report Insights

• Gastrointestinal Stromal Tumor (GIST) Patient Population Forecast

• Gastrointestinal Stromal Tumor (GIST) Therapeutics Market Size 

• Gastrointestinal Stromal Tumor (GIST) Pipeline Analysis

• Gastrointestinal Stromal Tumor (GIST) Market Size and Trends

• Gastrointestinal Stromal Tumor (GIST) Market Opportunity (Current and forecasted)

Report Key Strengths

• Epidemiology‑based (Epi‑based) Bottom‑up Forecasting

• Artificial Intelligence (AI)-Enabled Market Research Report 

• 11-Year Forecast 

• Gastrointestinal Stromal Tumor (GIST) Market Outlook (North America, Europe, Asia-Pacific) 

• Patient Burden Trends (By Geography)

• Gastrointestinal Stromal Tumor (GIST) Treatment Addressable Market (TAM)

• Gastrointestinal Stromal Tumor (GIST) Competitve Landscape

• Gastrointestinal Stromal Tumor (GIST)) Major Companies Insights

• Gastrointestinal Stromal Tumor (GIST) Price Trends and Analogue Assessment

• Gastrointestinal Stromal Tumor (GIST) Therapies Drug Adoption/Uptake

• Gastrointestinal Stromal Tumor (GIST) Therapies Peak Patient Share Analysis

Report Assessment

• Gastrointestinal Stromal Tumor (GIST) Current Treatment Practices

• Gastrointestinal Stromal Tumor (GIST) Unmet Needs

• Gastrointestinal Stromal Tumor (GIST) Clinical Development Analysis

• Gastrointestinal Stromal Tumor (GIST) Emerging Drugs Product Profiles

• Gastrointestinal Stromal Tumor (GIST) Market attractiveness

• Gastrointestinal Stromal Tumor (GIST) Qualitative Analysis (SWOT and conjoint analysis)

FAQs

Market Insights

• What was the GIST market size, the market size by therapies, market share (%) distribution in 2025, and what would it look like by 2036? What are the contributing factors for this growth?

• What are the anticipated pricing variations among different geographies for the emerging therapies in the future?

• What can be the future treatment paradigm of GIST?

• What are the disease risks, burdens, and unmet needs of GIST? What will be the growth opportunities across the 7MM concerning the patient population with GIST?

• Who is the major future competitor in the market, and how will the competitors affect their market share?

• What are the current options for the treatment of GIST? What are the current guidelines for treating GIST in the US, Europe, and Japan?

Reasons to Buy

• The report will help in developing business strategies by understanding the latest trends and changing treatment dynamics driving the GIST market.

• Bottom-up forecasting builds from the affected population to product forecasts, delivering a robust, data-driven approach ideal for new therapies and novel classes.

• Insights on patient burden/disease incidence, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.

• Understand the existing market opportunities in varying geographies and the growth potential over the coming years.

• Identifying strong upcoming players in the market will help devise strategies to help get ahead of competitors.

• Detailed analysis and ranking of class-wise potential current and emerging therapies under the conjoint analysis section to provide visibility around leading classes.

• To understand KOLs’ perspectives on the accessibility, acceptability, and compliance-related challenges of existing treatment to overcome barriers in the future.

• Detailed insights on the unmet needs of the existing market so that the upcoming players can strengthen their development and launch strategy.

• This Artificial Intelligence (AI)-enabled report summarize and simplify complex datasets with in the report into clear, actionable insights for stakeholders, investors, and healthcare providers, enabling faster, data-driven decisions.