Clinical management of gastrointestinal stromal tumors: Before and after STI-571

摘要: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of gastrointestinal tract. Until recently, surgery has been only effective therapy for GIST. However, even after complete resection tumor, many patients still eventually die disease recurrence. Conventional chemotherapy and radiation have limited value. Within last few years, it was discovered that GISTs a gain-of-function mutation in c-kit proto-oncogene. This results ligand-independent activation KIT receptor tyrosine kinase an unopposed stimulus cell growth. STI-571 small molecule selectively inhibits enzymatic activity ABL, platelet-derived growth factor receptor, kinases BCR-ABL fusion protein landmark development cancer therapy. Its clinical marks new era rational targeted molecular inhibition emanates from direct collaborations between scientists clinicians. It provides proof principle specific inhibitor can drastically alter survival neoplastic with particular genetic aberration. The advent markedly altered approach to proven be metastatic GIST also under investigation as neoadjuvant adjuvant