Advanced gastrointestinal stromal tumor in Europe: a review of updated treatment recommendations

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.

Keywords::

• ESMO recommendations
• gastrointestinal stromal tumor
• imatinib mesylate
• sunitinib malate
• tyrosine kinase inhibitor

Financial & competing interests disclosure

Jean-Yves Blay has received research grants and honoraria from Pfizer and Novartis; Peter Reichardt has received honoraria from Novartis and Pfizer. Peter reichardt is also a member of Advisory Boards for Novartis and Pfizer and has received research grants from Novartis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance was utilized in the production of this manuscript. Editorial support was provided by ACUMED (Tytherington, UK), with funding from Pfizer Inc.

Notes

Data from [46,48,103]