NCCN Task Force Report: Management of Patients with Gastrointestinal Stromal Tumor (GIST)—Update of the NCCN Clinical Practice Guidelines

Abstract

<jats:p>The NCCN Soft Tissue Sarcoma Guidelines include a subsection about treatment recommendations for gastrointestinal stromal tumors (GISTs). The standard of practice rapidly changed after the introduction of effective molecularly targeted therapy (such as imatinib and sunitinib) for GIST. Because of these changes, NCCN organized a multidisciplinary panel composed of experts in the fields of medical oncology, molecular diagnostics, pathology, radiation oncology, and surgery to discuss the optimal approach for the care of patients with GIST at all stages of the disease. The GIST Task Force is composed of NCCN faculty and other key experts from the United States, Europe, and Australia. The Task Force met for the first time in October 2003 and again in December 2006 with the purpose of expanding on the existing NCCN guidelines for gastrointestinal sarcomas and identifying areas of future research to optimize our understanding and treatment of GIST. (<jats:italic>JNCCN</jats:italic> 2007;5[Suppl 2]:S1–S29)</jats:p>

Analysis of long‐term survival after hepatectomy for isolated liver metastasis of gastrointestinal stromal tumour

“…Abdominal drain was not routinely deployed. From 2008, adjuvant therapy using imatinib mesylate (200–400 mg/day) was given after hepatectomy …”

Consensus approaches to best practice management of gastrointestinal stromal tumors

“…usually within 6–12 months of starting imatinib treatment. Patients who have resection of metastatic disease need to continue imatinib after surgery 25 …”

“…Response to imatinib is assessed with contrast‐enhanced CT with or without fluorodeoxyglucose‐positron emission tomography (FDG‐PET) scanning. FDG‐PET is a good early marker of tumor response to imatinib 12,25 . Even in those patients in whom a baseline FDG‐PET is not performed, an on‐treatment PET that is negative can be informative because PET response is usually complete 25 .…”

“…FDG‐PET is a good early marker of tumor response to imatinib 12,25 . Even in those patients in whom a baseline FDG‐PET is not performed, an on‐treatment PET that is negative can be informative because PET response is usually complete 25 . FDG‐PET is also useful in detecting the emergence of resistant clones; however, it is expensive and not as widely available as CT 25 …”

Robotic management of gastric stromal tumors (GIST): a single Middle Eastern center experience

“…They can originate anywhere within the gastrointestinal tract. The stomach is the most common site of GIST followed by the small intestine . GISTs are driven by mutations in one of the receptors tyrosine kinases (KIT or CD117) or platelet‐derived growth factor receptor alpha (PDGFRA).…”