Optimal procedures in systemic treatment of gastrointestinal stromal tumors: current procedures, novelties, treatment perspectives

04/2017

MUDr. Beatrix Bencsiková, Ph.D.

Masarykův onkologický ústav, Brno

SUMMARY

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of gastrointestinal tract. Oncogenic activating mutations in the receptor tyrosine kinases KIT (78 %) and PDGFRA (platelet-derived growth factor receptor alpha; 5-8 %) play a crucial role in the molecular pathogenesis of GIST. Better treatment strategies and targeted therapies have improved survival rates for patients with GIST significantly. Imatinib, the receptor tyrosine kinase inhibitor, has revolutionized the therapeutic landscape for GIST patients and remains the mainstay first-line clinical option for both unresectable and advanced GISTs, as well as for adjuvant treatment after resection of high risk GIST. Sunitinib is indicated as second-line therapy. Regorafenib has been approved as third-line treatment of patients who progressed on or are intolerant to prior imatinib and sunitinib. Early identification of patients with suboptimal response to therapy is an important issue of a personalized treatment of patients with GIST.

KEY WORDS

gastrointestinal stromal tumors, targeted therapy, imatinib, sunitinib, regorafenib