Investigating vimseltinib in tenosynovial giant cell tumors.
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INTRODUCTION: Tenosynovial giant cell tumors (TGCTs) are locally aggressive mesenchymal neoplasms that can cause chronic disability. Surgery is a mainstay of treatment but can carry a high risk of morbidity or can confer limited benefit. As such, effective alternative treatment options are needed, including systemic agents. Improved understanding of the pathophysiology of TGCTs has led to such drug development. AREAS COVERED: Vimseltinib is a switch-control tyrosine kinase inhibitor designed to selectively inhibit CSF1R, which, along with CSF1, is responsible for the synovial inflammation that characterizes TGCTs. In this drug evaluation, we review the mechanism of action, pharmacologic properties, clinical efficacy and current role within the TGCT treatment landscape of vimseltinib. EXPERT OPINION: Vimseltinib demonstrated a significant response rate as well as meaningful symptomatic improvement in patients with TGCTs. Furthermore, there is an absence of severe toxicities that have arisen with other agents in the TGCT treatment space, specifically liver failure. Vimseltinib is a favorable option for patients with TGCTs and further efforts to determine its place in the sequence of overall management are needed.