Gastrointestinal Stromal Tumors (GIST) and Their Management

Gastrointestinal stromal tumor (GIST) is the most common form of sarcoma and can vary in size and clinical outcome from an incidental finding at the time of surgery to life-threatening metastatic disease. Surgery is the standard of care for primary disease, and the oral drug imatinib is the standard of care for metastatic disease. Sunitinib was approved in the United States in early 2006 for GIST refractory to imatinib. The pathology of GIST, surgical options for primary and metastatic disease, and findings leading to the use of imatinib and sunitinib for GIST are reviewed in this manuscript, with attention to the mutation statuses of c-kit and PDGF receptor that lead to imatinib sensitivity or resistance.