Controversies in the surgical management of GIST in the era of imatinib.
Because of its relatively low toxicity and significant efficacy in the treatment of GIST, imatinib has dramatically altered the natural history of this disease. Early studies, however, have not adequately addressed the optimal length and dose of adjuvant and neoadjuvant imatinib therapy, defined the subset of candidates most likely to benefit from such therapy, determined the long-term impact on OS and use of second-line therapy, nor evaluated the extent and timing of surgery in patients with metastatic disease. With the expectation that advances in biology will lead to more effective chemotherapy for a variety of solid tumors, lessons learned in GIST management will provide a model for multimodality treatment that can be broadly applied.
Raut
Chandrajit P
CP
Department of Surgery, Brigham and Women's Hospital Dana-Farber Cancer Institute, Harvard Medical School, USA.
Bertagnolli
Monica M
MM
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D017024:Chemotherapy, Adjuvant; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D007211:Indoles / Q000627:therapeutic use*; D020360:Neoadjuvant Therapy; D010879:Piperazines / Q000627:therapeutic use*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D000077210:Sunitinib
D000970:Antineoplastic Agents; D001549:Benzamides; D007211:Indoles; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D000068877:Imatinib Mesylate; D000077210:Sunitinib