Comment on Golčić et al. Evaluation of Systemic Treatment Options for Gastrointestinal Stromal Tumours. Cancers 2023, 15, 4081

Abstract

We carefully read the article written by Golčić et al. “Evaluation of Systemic Treatment Options for Gastrointestinal Stromal Tumours” [...]

Reply to Chen, A.; Zhang, X. Comment on “Golčić et al. Evaluation of Systemic Treatment Options for Gastrointestinal Stromal Tumours. Cancers 2023, 15, 4081”

“…Secondly, we concur with Chen et al [2] that the table titled "Systemic Therapy Agents and Regimens for Unresectable, Progressive, or Metastatic Disease" in the National Comprehensive Cancer Network (NCCN) Guidelines does not explicitly mention imatinib dose elevation in the second-line treatment [4]. However, we point Chen et al towards the treatment algorithm in the same guidelines (GIST-4 and GIST-5), which clearly state that the dose escalation of imatinib is an option upon progression on imatinib 400 mg, along with a switch to alternative tyrosine kinase inhibitors (TKI).…”

“…Firstly, we agree with Chen et al [2] that the European Society for Medical Oncology (ESMO) Guidelines state sunitinib is the standard second-line treatment for patients with advanced GIST [3]. However, the choice of the second-line treatment option depends on the GIST mutational status and the availability of the drug.…”

“…Thirdly, the authors comment that the dose escalation of imatinib does not fall under the category of second-line treatment [2]. However, we disagree with such a statement due to several reasons.…”