Abstract
The European Society for Medical Oncology (ESMO) recommendations on the management of gastrointestinal stromal tumor (GIST) have recently been updated. Imatinib 400 mg/day remains the standard first-line treatment for patients with metastatic GIST. Mutational analysis has received a strong recommendation for diagnostic purposes. Furthermore, patients with KIT exon 9-activating mutations are now recommended to receive imatinib 800 mg/day as first-line treatment. Following progression during treatment with imatinib 400 mg/day, increasing the imatinib dose to 800 mg/day is advised. In the case of further progression or intolerance to imatinib, sunitinib 50 mg/day (schedule 4/2) is recommended. This article reviews the evidence underlying the updates to the ESMO recommendations on the management of GIST and discusses the implications of the changes.
MeSH terms
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Antineoplastic Agents / administration & dosage
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Antineoplastic Agents / therapeutic use*
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Benzamides
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DNA Mutational Analysis
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Disease Progression
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Europe / epidemiology
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Gastrointestinal Stromal Tumors / drug therapy*
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Gastrointestinal Stromal Tumors / genetics
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Gastrointestinal Stromal Tumors / pathology
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Humans
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Imatinib Mesylate
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Indoles / administration & dosage
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Indoles / therapeutic use
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Mutation
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Neoplasm Metastasis
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Piperazines / administration & dosage
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Piperazines / therapeutic use*
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Practice Guidelines as Topic
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Proto-Oncogene Proteins c-kit / genetics
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Pyrimidines / administration & dosage
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Pyrimidines / therapeutic use*
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Pyrroles / administration & dosage
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Pyrroles / therapeutic use
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Sunitinib
Substances
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Antineoplastic Agents
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Benzamides
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Indoles
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Piperazines
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Pyrimidines
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Pyrroles
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Imatinib Mesylate
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Proto-Oncogene Proteins c-kit
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Sunitinib