Patient description: The patient is a 31-year-old woman complaining of abdominal pain. The pain started last night as diffuse abdominal discomfort. She had poor appetite as well as malaise. The pain worsened in intensity and became sharp in the morning. The pain became localized to the right lower quadrant in the morning. The temperature is within the normal limits with normal vital signs. Focal tenderness and guarding were observed during palpation of the right lower quadrant. Palpation of the left lower quadrant causes pain on the right. Her lab work is remarkable for leukocytosis. Computed Tomography of the abdomen with contrast shows the presence of a distended appendix with thickened appendiceal wall without perforation, abscess or gangrene. She is a candidate for laparoscopic appendectomy under general anesthesia.

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Gastro Intestinal Stromal Tumour I1. Male or female ≥ 18 years at the day of consenting to the study. I2. Patient must have histologically confirmed diagnosis of GIST. I3. Disease must be locally advanced or metastatic. I4. Patient who failed (disease progression and/or intolerance) previously at least to imatinib and sunitinib. Nota Bene: patients with more than 2 previous anticancer treatments are eligible. I5. Patient must have evidence of measurable disease as per the version 1.1 (Appendix 2). I6. Patient must have documented disease progression. I7. ECOG performance status 0, 1 or 2 (Appendix 3). I8. Patient must have normal organ and bone marrow function as defined below Hematologic Absolute neutrophil count (ANC) ≥ 1.5 Gi/L Haemoglobin ≥ 9 g/dl (5.6 mmol/l) (subjects may not have had a transfusion within 7 days of screening assessment) Platelets ≥ 100 Gi/l Coagulation panel Prothrombin time (PT) or international normalized ratio (INR) ≤ 1.2 X upper limit of normal (ULN) Partial thromboplastin time (PTT) ≤ 1.2 X ULN Subjects receiving anticoagulant therapy are eligible if their INR is stable and within the recommended range for the desired level of anticoagulation Hepatic Total bilirubin ≤ 1.5 X ULN  E1. Patient with a documented mutation in exon 18 (D842V substitution). E2. Clinically significant gastrointestinal abnormalities that may increase the risk for gastrointestinal bleeding including, but not limited to Active peptic ulcer disease Known intraluminal metastatic lesions with risk of bleeding Inflammatory bowel disease (e.g. ulcerative colitis, Crohn's disease), or other gastrointestinal conditions with increased risk of perforation History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 28 days prior to beginning study treatment Clinically significant gastrointestinal abnormalities that may affect absorption of investigational product including, but not limited to Malabsorption syndrome Major resection of the stomach or small bowel. E3. Any active/uncontrolled infection, including known infection with HIV, Hepatitis B or Hepatitis C. E4. Corrected QT interval (QTc) > 480 msecs using Bazett's formula E5. History of any one or more of the following cardiovascular conditions within the past 6 months prior to the first dose of study drug Cardiac angioplasty or stenting Myocardial infarction