Current management and prognostic features for gastrointestinal stromal tumor (GIST)

Abstract

Stromal or mesenchymal neoplasms affecting the gastrointestinal (GI) tract have undergone a remarkable evolution in how they are perceived, classified, approached, diagnosed and managed over the last 30 years. Gastrointestinal stromal tumors (GIST) account for approximately 1% to 3% of all malignant GI tumors. The clinical features can vary depending on the anatomic location, size and aggressiveness of the tumor. Metastatic GIST represents a successful example of molecular targeted therapy. In this comprehensive review, we discuss the epidemiology, clinical features and diagnostic modalities for GIST. We also describe treatment options for early stage, locally advanced and metastatic GIST. Indications for neoadjuvant and adjuvant therapy along with duration of therapy are also explained. A brief discussion of latest biomarkers and updates from recent meetings is also provided.

Figure 1

The structure of KIT/CD117 and the signal transduction. KIT is a transmembrane receptor type tyrosine knase. The stem cell factor/KIT ligand binds to KIT and activates the KIT tyrosine kinase. The phosphorylated (activated) KIT then activates its substrates which lead to cell proliferation.