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Updated: Sep 12, 2025
Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors
Published on: February 19, 2022
Present management of gastrointestinal stromal tumors
Background:
Gastrointestinal stromal tumors (GISTs) are rare tumors of the digestive tract that have seen significant advances in diagnosis and treatment in recent years. A key breakthrough was the identification of c-KIT and PDGFRA gene mutations, which enabled the introduction of targeted therapies. The cornerstone of the treatment for localized disease is radical (R0) surgical resection, with adjuvant imatinib recommended for patients at high risk of recurrence. In advanced or metastatic disease, standard care involves sequential treatment with tyrosine kinase inhibitors, including imatinib, sunitinib, and regorafenib. A major advance is represented by ripretinib, which effectively inhibits a broad spectrum of KIT and PDGFRA mutations and has been shown to prolong survival in patients with advanced GIST refractory to current options of systemic therapy. The expanding range of targeted therapies, such as avapritinib for the PDGFRA D842V mutation, underscores the importance of molecular profiling in guiding optimal treatment strategies.
Aim:
This review aims to summarize current knowledge on the diagnosis and treatment of GIST, with a focus on the role of molecular-genetic profiling, the therapeutic value of individual tyrosine kinase inhibitors, and emerging options for advanced disease, with particular emphasis on ripretinib.
Insights
Gastrointestinal stromal tumors (GISTs) treatment advances include targeted therapies based on gene mutations. Molecular profiling guides optimal strategies, with ripretinib offering new hope for advanced GIST patients.
Area of Science:
- Oncology
- Gastroenterology
- Molecular Biology
Background:
- Gastrointestinal stromal tumors (GISTs) are rare digestive tract neoplasms.
- Discovery of c-KIT and PDGFRA mutations revolutionized GIST treatment with targeted therapies.
- Current management involves surgery for localized disease and tyrosine kinase inhibitors for advanced stages.
Purpose of the Study:
- To review current GIST diagnosis and treatment strategies.
- To highlight the role of molecular-genetic profiling in personalized therapy.
- To discuss the efficacy of tyrosine kinase inhibitors, including ripretinib for advanced GIST.
Main Methods:
- Literature review of diagnostic and therapeutic advances in GIST.
- Analysis of the role of molecular profiling in treatment selection.
- Evaluation of tyrosine kinase inhibitors, focusing on ripretinib's efficacy.
Main Results:
- Targeted therapies, driven by c-KIT/PDGFRA mutations, have significantly improved GIST outcomes.
- Ripretinib demonstrates efficacy in advanced GIST refractory to other treatments, prolonging survival.
- Specific mutations, like PDGFRA D842V, are targeted by agents such as avapritinib.
Conclusions:
- Molecular profiling is crucial for guiding optimal GIST treatment selection.
- Ripretinib represents a significant advancement for refractory advanced GIST.
- Ongoing research continues to expand targeted therapeutic options for GIST.
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