Shreyaskumar R. Patel, MD; Priscilla Merriam, MD; Richard F. Riedel, MD; and Gina Z. D'Amato, MD, discuss how gastrointestinal stromal tumors require comprehensive mutational analysis to guide targeted kinase inhibitor therapy, emphasizing the importance of patient adherence, proactive adverse effect management, and maintaining some form of kinase inhibition even after progression to maximize disease control and quality of life.
Panelists discuss how gastrointestinal stromal tumors (GISTs) are the most common sarcoma with specific genetic mutations, requiring comprehensive mutational analysis to guide treatment decisions and understand both primary and secondary resistance patterns.
Panelists discuss how mutational testing is critical for gastrointestinal stromal tumor (GIST) management, with different genetic alterations determining treatment sensitivity and the importance of understanding both primary drivers and secondary resistance mutations that develop over time.
Panelists discuss how standard-of-care treatment follows NCCN guidelines with sequential kinase inhibitor therapy (imatinib, sunitinib, regorafenib, ripretinib), emphasizing that maintaining some form of kinase inhibition is always preferable to no treatment even after progression.
Panelists discuss how patient adherence to kinase inhibitors is crucial for disease control, requiring proactive adverse effect management, careful radiological monitoring, and strategies such as dose escalation to maximize treatment duration and effectiveness.
Panelists discuss how most gastrointestinal stromal tumor (GIST) patients can tolerate approved agents with proper adverse effect management, the efficacy data from the INVICTUS and INTRIGUE trials that led to ripretinib's approval, and the unique adverse effects such as alopecia that distinguish ripretinib from other therapies.
Panelists discuss how newer clinical trials such as PEAK and INSIGHT are investigating combination therapies and mutation-specific treatment approaches to overcome secondary resistance mutations, while also exploring pan-KIT inhibitors and senescence-targeting strategies to improve outcomes.
Panelists discuss how communication between community oncologists and academic centers is essential for advancing gastrointestinal stromal tumor (GIST) treatment through clinical trial participation, molecular analysis, and the promising future of personalized therapy based on individual tumor mutation profiles.
