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Opinion|Videos|March 31, 2025

Biological Mechanisms of GIST Resistance and Tumor Heterogeneity

Author(s)Breelyn Wilky, MD, Jason Sicklick, MD, FACS, Seth M. Pollack, MD

Experts discuss the biological mechanisms of resistance in gastrointestinal stromal tumors (GIST), differentiating between primary and secondary resistance, and explore how tumor heterogeneity evolves throughout treatment, with implications for long-term management and treatment strategies.

Episodes in this series

EP. 1 Optimizing TKI Selection and Sequencing Strategies in Advanced GIST Beyond First-Line Therapy

EP. 1 Optimizing TKI Selection and Sequencing Strategies in Advanced GIST Beyond First-Line Therapy

EP. 2 Biological Mechanisms of GIST Resistance and Tumor Heterogeneity

EP. 2 Biological Mechanisms of GIST Resistance and Tumor Heterogeneity

EP. 3 Monitoring Tumor Heterogeneity and Detecting Resistance

EP. 3 Monitoring Tumor Heterogeneity and Detecting Resistance

EP. 4 Post-Imatinib Progression: Decision Factors and Treatment Options

EP. 4 Post-Imatinib Progression: Decision Factors and Treatment Options

EP. 5 INVICTUS Trial: Ripretinib in Fourth-Line Setting

EP. 5 INVICTUS Trial: Ripretinib in Fourth-Line Setting

EP. 6 INTRIGUE Trial: Key Findings in Second-Line Setting

EP. 6 INTRIGUE Trial: Key Findings in Second-Line Setting

EP. 7 ctDNA Biomarkers in INTRIGUE: Understanding Resistance Patterns

EP. 7 ctDNA Biomarkers in INTRIGUE: Understanding Resistance Patterns

EP. 8 Managing Adverse Events With Different TKIs

EP. 8 Managing Adverse Events With Different TKIs

EP. 9 Next-Generation Treatment Strategies for GIST: Evaluating Combination Therapies and Mutation-Specific Approaches

EP. 9 Next-Generation Treatment Strategies for GIST: Evaluating Combination Therapies and Mutation-Specific Approaches

EP. 10 Practical Recommendations for Community Oncologists

EP. 10 Practical Recommendations for Community Oncologists

Video content above is prompted by the following:

Let’s start with the fundamentals of resistance in GIST. Could you explain the biological mechanisms of resistance in GIST? Could you differentiate between primary and secondary resistance in GIST and explain how each impacts your treatment approach?
How does tumor heterogeneity evolve throughout treatment course, and what implications does this have for long-term management?

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