Gastrointestinal stromal tumours (GIST) — 2018

Abstract

Gastrointestinal stromal tumours (GIST) are the most common mesenchymal tumours of gastrointestinal tract. Advances in the understanding of the pathologic-molecular mechanisms of GIST pathogenesis have emerged GIST as a model of targeted therapy in oncology. The paper describes advances in diagnostics and therapy of these tumours based on new scientific basis. Radical surgery is still the mainstay treatment for primary, localized, resectable GISTs, although high percentages of the patients after potentially curative operations develop recurrent or metastatic disease; thus all GIST should be evaluated for potential adjuvant therapy with imatinib. In inoperable/metastatic lesions the treatment of choice is tyrosine kinase inhibitor — imatinib mesylate In case of disease progression the increase of imatinib dose to 800 mg daily is recommended and if further progression exists — sunitinib in the initial dose 50 mg daily should be introduced, thereafter sorafenib/regorafenib or clinical trial with new drugs (e.g. BLU-285 or DCC2618).