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Erschienen in: memo - Magazine of European Medical Oncology 3/2018

28.08.2018 | short review

Cure in metastatic disease: how to manage and who is the right patient in GIST

verfasst von: Ursula Pluschnig, MD

Erschienen in: memo - Magazine of European Medical Oncology | Ausgabe 3/2018

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Summary

Gastrointestinal stromal tumors (GISTs) are a rare type of cancer and a heterogeneous disease. The tyrosine kinase receptors KIT and the platelet-derived growth factor receptor alpha PDGFRA are the most common mutant genes of GIST. Mutation analysis is a diagnostic standard and is crucial for drug therapy with tyrosine kinase inhibitors (TKI). About 10% of patients already have metastases at first diagnosis. R0 resection is the only curative option in GIST and is therefore the therapy for localized tumors. In case of locally advanced primary tumors, neoadjuvant therapy should be offered. Recurrent, metastatic and locally advanced disease can be treated with TKI; in select cases surgical therapy may be added. The role of surgery in metastatic disease is controversial.
Literatur
1.
Zurück zum Zitat Hirota S, et al. Gain-of-function mutations of c‑kit in human gastrointestinal stromal tumors. Science. 1998;279(5350):577–80.CrossRefPubMed Hirota S, et al. Gain-of-function mutations of c‑kit in human gastrointestinal stromal tumors. Science. 1998;279(5350):577–80.CrossRefPubMed
3.
Zurück zum Zitat DeMatteo RP, et al. Tumor mitotic rate, size, and location independently predict recurrence after resection of primary gastrointestinal stromal tumor (GIST). Cancer. 2008;112:608–15.CrossRefPubMed DeMatteo RP, et al. Tumor mitotic rate, size, and location independently predict recurrence after resection of primary gastrointestinal stromal tumor (GIST). Cancer. 2008;112:608–15.CrossRefPubMed
4.
Zurück zum Zitat Miettinen M, Lasota J, et al. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70–83.CrossRefPubMed Miettinen M, Lasota J, et al. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70–83.CrossRefPubMed
5.
Zurück zum Zitat Choi H, et al. Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria. J Clin Oncol. 2007;25(13):1753–9.CrossRefPubMed Choi H, et al. Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria. J Clin Oncol. 2007;25(13):1753–9.CrossRefPubMed
10.
Zurück zum Zitat De Matteo RP, et al. Adjuvant imatinib mesylate after resection of localized, primary gastrointestinal stromal tumour: a randomized, double blind,placebo controlled trial. Lancet. 2009;373:1097–104.CrossRef De Matteo RP, et al. Adjuvant imatinib mesylate after resection of localized, primary gastrointestinal stromal tumour: a randomized, double blind,placebo controlled trial. Lancet. 2009;373:1097–104.CrossRef
11.
Zurück zum Zitat Casali PG, et al. Gastrointestinal stromal tumours: ESMO ClinicalPractice Guidelines for diagnosis, treatment and follow-u. Ann Oncol. 2010;21(Suppl. 5):98–102.CrossRef Casali PG, et al. Gastrointestinal stromal tumours: ESMO ClinicalPractice Guidelines for diagnosis, treatment and follow-u. Ann Oncol. 2010;21(Suppl. 5):98–102.CrossRef
12.
Zurück zum Zitat De Matteo RP, et al. Long term results of adjuvant imatinib mesylate in localized, high-risk, primary gastrointestinal stromal tumor: ACOSOG Z9000 (Alliance) intergroup phase 2 trial. Ann Surg. 2013;258:422–9.CrossRef De Matteo RP, et al. Long term results of adjuvant imatinib mesylate in localized, high-risk, primary gastrointestinal stromal tumor: ACOSOG Z9000 (Alliance) intergroup phase 2 trial. Ann Surg. 2013;258:422–9.CrossRef
13.
Zurück zum Zitat Corless CL, et al. Pathologic and molecular features correlate with long-term outcome after adjuvant therapy of resected primary GI stromal tumor: the ACOSOG Z9001 trial. J Clin Oncol. 2014;32:1563–70.CrossRefPubMedPubMedCentral Corless CL, et al. Pathologic and molecular features correlate with long-term outcome after adjuvant therapy of resected primary GI stromal tumor: the ACOSOG Z9001 trial. J Clin Oncol. 2014;32:1563–70.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Joensuu H, et al. One vs three years of adjuvant imatinib for operable gastrointestinal stromal tumor: a randomized trial. JAMA. 2012;307(12):1265–72.CrossRefPubMed Joensuu H, et al. One vs three years of adjuvant imatinib for operable gastrointestinal stromal tumor: a randomized trial. JAMA. 2012;307(12):1265–72.CrossRefPubMed
18.
Zurück zum Zitat ESMO/European Sarcoma Network Working Group. Gastrointestinal stromal tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25(Suppl 3):iii21–iii6.CrossRef ESMO/European Sarcoma Network Working Group. Gastrointestinal stromal tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25(Suppl 3):iii21–iii6.CrossRef
19.
Zurück zum Zitat von Mehren M, et al. Soft Tissue Sarcoma, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2016;14(6):758–86.CrossRef von Mehren M, et al. Soft Tissue Sarcoma, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2016;14(6):758–86.CrossRef
20.
Zurück zum Zitat Demetri GD, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumours. N Eng J Med. 2002;347:472–80.CrossRef Demetri GD, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumours. N Eng J Med. 2002;347:472–80.CrossRef
23.
Zurück zum Zitat Reichardt P, et al. Leitlinie Gastrointestinale Stromatumoren. Onkopedia. 2011;6. Reichardt P, et al. Leitlinie Gastrointestinale Stromatumoren. Onkopedia. 2011;6.
24.
Zurück zum Zitat Raut CP et al. Surgical management of advanced gastrointestinal stromal tumors after treatment with targeted systemic therapy using kinase inhibitors. J Clin Oncol 2006;24:2325–31.CrossRefPubMed Raut CP et al. Surgical management of advanced gastrointestinal stromal tumors after treatment with targeted systemic therapy using kinase inhibitors. J Clin Oncol 2006;24:2325–31.CrossRefPubMed
25.
Zurück zum Zitat Bonvalot S et al. Impact of surgery on advanced gastrointestinal stromal tumors (GIST) in the imatinib era. Ann Surg Oncol 2006;13(12):1596–603.CrossRef Bonvalot S et al. Impact of surgery on advanced gastrointestinal stromal tumors (GIST) in the imatinib era. Ann Surg Oncol 2006;13(12):1596–603.CrossRef
26.
Zurück zum Zitat Demetri GD, et al. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: a randomised controlled trial. Lancet. 2006;368:1329.CrossRefPubMed Demetri GD, et al. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: a randomised controlled trial. Lancet. 2006;368:1329.CrossRefPubMed
27.
Zurück zum Zitat Demetri GD, et al. Efficacy and safety of regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib (GRID): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013;381:295–302.CrossRefPubMed Demetri GD, et al. Efficacy and safety of regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib (GRID): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013;381:295–302.CrossRefPubMed
29.
Zurück zum Zitat Heinrich MC, et al. A phase 2 study of ponatinib in patients with advanced gastrointestinal stromal tumors (GIST) after failure of tyrosine kinase inhibitor (TKI) therapy: initial report. J Clin Oncol. 2014;32(15S):669s. abstract #10506. Heinrich MC, et al. A phase 2 study of ponatinib in patients with advanced gastrointestinal stromal tumors (GIST) after failure of tyrosine kinase inhibitor (TKI) therapy: initial report. J Clin Oncol. 2014;32(15S):669s. abstract #10506.
32.
Zurück zum Zitat Ford SJ, Gronchi A, et al. Indications for surgery in advanced/metastatic GIST. Eur J Cancer. 2016;63:154–67.CrossRefPubMed Ford SJ, Gronchi A, et al. Indications for surgery in advanced/metastatic GIST. Eur J Cancer. 2016;63:154–67.CrossRefPubMed
34.
Zurück zum Zitat Bauer S, et al. Long-term follow-up of patients with GIST undergoing metastasectomy in the era of imatinib—analysis of prognostic factors (EORTC-STBSG collaborative study). Eur J Surg Oncol. 2014;40(4):412–9.CrossRefPubMed Bauer S, et al. Long-term follow-up of patients with GIST undergoing metastasectomy in the era of imatinib—analysis of prognostic factors (EORTC-STBSG collaborative study). Eur J Surg Oncol. 2014;40(4):412–9.CrossRefPubMed
35.
Zurück zum Zitat Casali PG, et al. Soft tissue and visceral sarcomas: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow up. Ann Oncol. 2018;0(Supplement 0):iv1–iv17. Casali PG, et al. Soft tissue and visceral sarcomas: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow up. Ann Oncol. 2018;0(Supplement 0):iv1–iv17.
36.
Zurück zum Zitat Rubio-Casadevall J, et al. Role of surgery in patients with recurrent, metastatic, or unresectable locally advanced gastrointestinal Stromal tumors sensitive to Imatinib: a retrospective analysis of the Spanish group for research on sarcoma (GEIS). Ann Surg Oncol. 2015;22:2948–57.CrossRefPubMed Rubio-Casadevall J, et al. Role of surgery in patients with recurrent, metastatic, or unresectable locally advanced gastrointestinal Stromal tumors sensitive to Imatinib: a retrospective analysis of the Spanish group for research on sarcoma (GEIS). Ann Surg Oncol. 2015;22:2948–57.CrossRefPubMed
37.
Zurück zum Zitat Vassos N, et al. Management of liver metastases of gastrointestinal stromal tumours (GIST). Ann Hepatol. 2015;14(4):531–9.PubMed Vassos N, et al. Management of liver metastases of gastrointestinal stromal tumours (GIST). Ann Hepatol. 2015;14(4):531–9.PubMed
Metadaten
Titel
Cure in metastatic disease: how to manage and who is the right patient in GIST
verfasst von
Ursula Pluschnig, MD
Publikationsdatum
28.08.2018
Verlag
Springer Vienna
Erschienen in
memo - Magazine of European Medical Oncology / Ausgabe 3/2018
Print ISSN: 1865-5041
Elektronische ISSN: 1865-5076
DOI
https://doi.org/10.1007/s12254-018-0432-y

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