[Treatment strategy for recurrent and metastatic gastrointestinal stromal tumors]

Area of Science:

• Oncology
• Gastroenterology

Background:

• Gastrointestinal stromal tumors (GIST) are a significant cause of cancer-related mortality.
• Recurrent or metastatic GIST presents a therapeutic challenge, necessitating advanced treatment strategies.

Purpose of the Study:

• To review the efficacy of targeted therapies and surgical interventions for recurrent/metastatic GIST.
• To highlight treatment options for patients who have failed imatinib therapy.

Main Methods:

• Literature review of targeted therapies for GIST.
• Analysis of outcomes for tyrosine kinase inhibitors (TKIs) and surgical resection.
• Evaluation of treatment effectiveness based on genetic mutations (e.g., c-kit exon 9).

Main Results:

• Sunitinib demonstrates efficacy in patients with advanced GIST, particularly those with c-kit exon 9 mutations and prior imatinib failure.
• Combination therapy with TKIs and partial hepatectomy may enhance overall survival in GIST patients with liver metastasis.
• Regorafenib and pazopanib show significant progression-free survival benefits post-standard treatment failure.

Conclusions:

• Targeted therapy is the primary treatment for advanced GIST.
• Surgical resection can be beneficial for select recurrent or metastatic GIST patients.
• Sequential TKI therapy and multimodal approaches offer improved outcomes for GIST management.