Gastrointestinal stromal tumors: Imatinib and beyond

Ian D. Schnadig, Charles D. Blanke

Research output: Contribution to journalReview articlepeer-review

32 Scopus citations


Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Clinicians previously classified GISTs as "benign" or "malignant," but now place resected tumors in risk categories that are based on size and mitotic rate. Historically, GIST patients were managed with surgery alone, as chemotherapy and radiotherapy have minimal activity in this disease. In the pre-imatinib era, patients with recurrent or metastatic disease generally did very poorly. GIST therapy was revolutionized following the discovery of oncogenic mutations in the c-kit gene, as well as in the platelet-derived growth factor receptor. Subsequently, it has been confirmed that the KIT receptor tyrosine kinase is both a diagnostic marker and a useful therapeutic target in GIST. Imatinib, a potent inhibitor of KIT activity, is now standard frontline therapy for advanced GIST. With the introduction of imatinib, there have been dramatic improvements in response rates, time to progression, and survival. Imatinib is now being investigated and shows promise in the neoadjuvant and adjuvant settings. Unfortunately, many patients eventually recur or progress during imatinib therapy. For these patients, imatinib dose escalation and/or surgical evaluation are appropriate. Additionally, a novel tyrosine kinase inhibitor such as SU11248 (sunitinib) is a reasonable option for progressive, imatinib-resistant disease. With the identification of other downstream pathways, several other promising therapies are under current investigation either alone or in combination with imatinib and surgery.

Original languageEnglish (US)
Pages (from-to)427-437
Number of pages11
JournalCurrent treatment options in oncology
Issue number6
StatePublished - Nov 2006

ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)


Dive into the research topics of 'Gastrointestinal stromal tumors: Imatinib and beyond'. Together they form a unique fingerprint.

Cite this