TREATMENT RECOMMENDATIONS FOR GISTs- DO NOT FORGET EXON 9 MUTATION

Expert Rev Anticancer Ther. 2009 Jun;9(6):831-8.

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

Blay JY, Reichardt P.

Cytokine and Cancer Unit, Léon Bérard Cancer Centre, 28 rue Laennec, 69008 Lyon, France. blay@lyon.fnclcc.fr

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.