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Updated: Dec 25, 2025
Molecular and Immunologic Techniques in a Genetically Engineered Mouse Model of Gastrointestinal Stromal Tumor
Published on: May 2, 2022
Progress in determining response to treatment in gastrointestinal stromal tumor
Junaid Arshad1, Jibran Ahmed2, Ty Subhawong1
1Miller School of Medicine/Sylvester Comprehensive Cancer Centre, University of Miami, Miami, FL, USA.
Abstract:
Introduction: Gastrointestinal stromal tumor (GIST) is the most common malignant mesenchymal tumor of the gastrointestinal system. Multiple advances in the management of GIST from the discovery of KIT/PDGRA and other genetic alterations have led to the development of multiple tyrosine kinase inhibitors. Response assessment in GIST is determined with iRECIST (Response Evaluation Criteria in Solid Tumors), PERCIST (PET response criteria in solid tumors), or Choi criteria. Molecular genotyping of the tissue samples is the recent standard for diagnosis, treatment, and response to treatment.Areas covered: In this study, we provide a brief overview of the history of the GIST, molecular sequencing, available treatment options and clinical trials, radiologic response assessment, and the role of ctDNA in response evaluation.Expert opinion: Future GIST management is related to the development of sensitive assays to detect genetic alterations for initial diagnosis, treatment selection, monitoring the response to treatment, resistant mutations, and predicting survival.
Insights
Gastrointestinal stromal tumors (GIST) management has advanced with targeted therapies and molecular diagnostics. Future directions focus on sensitive assays for genetic alterations to guide treatment and predict survival.
Area of Science:
- Oncology
- Gastroenterology
- Molecular Diagnostics
Background:
- Gastrointestinal stromal tumor (GIST) is the most common malignant mesenchymal tumor of the GI system.
- Advances in understanding KIT/PDGRA and other genetic alterations have driven the development of tyrosine kinase inhibitors.
- Current response assessment relies on criteria like iRECIST, PERCIST, or Choi criteria, with molecular genotyping as a diagnostic standard.
Purpose of the Study:
- To provide an overview of GIST history, molecular sequencing, and treatment options.
- To discuss radiologic response assessment methods in GIST.
- To explore the role of circulating tumor DNA (ctDNA) in evaluating treatment response.
Main Methods:
- Review of historical GIST management and molecular discoveries.
- Analysis of current treatment strategies, including tyrosine kinase inhibitors and clinical trials.
- Examination of established and emerging response evaluation criteria.
Main Results:
- Molecular genotyping is the current standard for GIST diagnosis, treatment selection, and response evaluation.
- Various imaging and molecular criteria are used to assess treatment efficacy.
- Circulating tumor DNA (ctDNA) shows promise in monitoring treatment response and detecting resistance.
Conclusions:
- Future GIST management hinges on developing sensitive assays for genetic alterations.
- These assays will aid in initial diagnosis, treatment selection, and monitoring response.
- Predicting survival and identifying resistant mutations are key future applications.
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