Evaluation of and Current Trends in the Management of Gastrointestinal Stromal Tumors: A Systematic Review

Gastrointestinal stromal tumors (GISTs) are soft-tissue sarcomas that can occur anywhere in the digestive tract, with the stomach and small intestine being the most common locations. Because no imaging modalities diagnose GIST unequivocally, histological and immunohistochemical confirmation is usual...

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Published inCurēus (Palo Alto, CA) Vol. 14; no. 7; p. e26848
Main Authors Arzoun, Hadia, Srinivasan, Mirra, Adam, Mona, Thomas, Siji S, Kuta, Amber, Sandoval, Stephanie
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 14.07.2022
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Abstract Gastrointestinal stromal tumors (GISTs) are soft-tissue sarcomas that can occur anywhere in the digestive tract, with the stomach and small intestine being the most common locations. Because no imaging modalities diagnose GIST unequivocally, histological and immunohistochemical confirmation is usually required. Most GISTs are discovered by chance; hence, determining this condition's actual frequency can be challenging. Since diagnosing the tumor could be difficult, including GIST in the differential diagnosis is crucial. The objective of this review is to explore the multiple treatment options for this tumor and provide clinicians with more information on the evolving treatment modalities, which in the future could be a possible solution to cure GIST ultimately. After exploring several studies, the authors conclude that early detection is critical since the treatment depends on the tumor size, mitotic rate, and location. Medical management using targeted therapy approved by the United States Food and Drug Administration (FDA) include tyrosine kinase inhibitors such as imatinib, sunitinib, and regorafenib. Surgical resection of the tumor is also done in cases with localized tumors. Standard chemotherapy and radiotherapy are not commonly used to treat GIST patients. However, radiotherapy may be used as a palliative therapy to ease pain (such as bone pain) or control bleeding. Additional research is needed to establish potential therapeutic targets that will result in higher and longer-term response rates.
AbstractList Gastrointestinal stromal tumors (GISTs) are soft-tissue sarcomas that can occur anywhere in the digestive tract, with the stomach and small intestine being the most common locations. Because no imaging modalities diagnose GIST unequivocally, histological and immunohistochemical confirmation is usually required. Most GISTs are discovered by chance; hence, determining this condition's actual frequency can be challenging. Since diagnosing the tumor could be difficult, including GIST in the differential diagnosis is crucial. The objective of this review is to explore the multiple treatment options for this tumor and provide clinicians with more information on the evolving treatment modalities, which in the future could be a possible solution to cure GIST ultimately. After exploring several studies, the authors conclude that early detection is critical since the treatment depends on the tumor size, mitotic rate, and location. Medical management using targeted therapy approved by the United States Food and Drug Administration (FDA) include tyrosine kinase inhibitors such as imatinib, sunitinib, and regorafenib. Surgical resection of the tumor is also done in cases with localized tumors. Standard chemotherapy and radiotherapy are not commonly used to treat GIST patients. However, radiotherapy may be used as a palliative therapy to ease pain (such as bone pain) or control bleeding. Additional research is needed to establish potential therapeutic targets that will result in higher and longer-term response rates.
Gastrointestinal stromal tumors (GISTs) are soft-tissue sarcomas that can occur anywhere in the digestive tract, with the stomach and small intestine being the most common locations. Because no imaging modalities diagnose GIST unequivocally, histological and immunohistochemical confirmation is usually required. Most GISTs are discovered by chance; hence, determining this condition's actual frequency can be challenging. Since diagnosing the tumor could be difficult, including GIST in the differential diagnosis is crucial. The objective of this review is to explore the multiple treatment options for this tumor and provide clinicians with more information on the evolving treatment modalities, which in the future could be a possible solution to cure GIST ultimately. After exploring several studies, the authors conclude that early detection is critical since the treatment depends on the tumor size, mitotic rate, and location. Medical management using targeted therapy approved by the United States Food and Drug Administration (FDA) include tyrosine kinase inhibitors such as imatinib, sunitinib, and regorafenib. Surgical resection of the tumor is also done in cases with localized tumors. Standard chemotherapy and radiotherapy are not commonly used to treat GIST patients. However, radiotherapy may be used as a palliative therapy to ease pain (such as bone pain) or control bleeding. Additional research is needed to establish potential therapeutic targets that will result in higher and longer-term response rates.Gastrointestinal stromal tumors (GISTs) are soft-tissue sarcomas that can occur anywhere in the digestive tract, with the stomach and small intestine being the most common locations. Because no imaging modalities diagnose GIST unequivocally, histological and immunohistochemical confirmation is usually required. Most GISTs are discovered by chance; hence, determining this condition's actual frequency can be challenging. Since diagnosing the tumor could be difficult, including GIST in the differential diagnosis is crucial. The objective of this review is to explore the multiple treatment options for this tumor and provide clinicians with more information on the evolving treatment modalities, which in the future could be a possible solution to cure GIST ultimately. After exploring several studies, the authors conclude that early detection is critical since the treatment depends on the tumor size, mitotic rate, and location. Medical management using targeted therapy approved by the United States Food and Drug Administration (FDA) include tyrosine kinase inhibitors such as imatinib, sunitinib, and regorafenib. Surgical resection of the tumor is also done in cases with localized tumors. Standard chemotherapy and radiotherapy are not commonly used to treat GIST patients. However, radiotherapy may be used as a palliative therapy to ease pain (such as bone pain) or control bleeding. Additional research is needed to establish potential therapeutic targets that will result in higher and longer-term response rates.
Author Thomas, Siji S
Kuta, Amber
Sandoval, Stephanie
Srinivasan, Mirra
Arzoun, Hadia
Adam, Mona
AuthorAffiliation 1 Internal Medicine, St. Bernards Medical Center, Jonesboro, USA
2 Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
3 Internal Medicine, St. Bernards Medical Center, Jonesboro , USA
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Cites_doi 10.1007/s10620-017-4533-y
10.1136/bmj.n71
10.3892/ol.2017.5925
10.4137/BIC.S25045
10.1038/s41416-019-0388-7
10.3389/fphys.2020.00230
10.12998/wjcc.v8.i15.3142
10.1186/s13045-020-01026-6
10.1016/j.ejso.2017.12.006
10.2147/OTT.S101385
10.2147/CMAR.S159689
10.1016/j.jpge.2015.12.007
10.21037/jgo.2018.08.20
10.5489/cuaj.4293
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Keywords current research
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gastrointestinal stromal tumors
drug therapy
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References Page MJ (ref14) 2021; 372
Bjarnason GA (ref17) 2016; 10
Zheng H (ref3) 2020; 11
Napolitano A (ref11) 2019; 120
ref1
Giestas S (ref2) 2016; 23
Ren H (ref6) 2017; 62
Kelly CM (ref13) 2021; 14
ref7
Liu Q (ref10) 2018; 10
Koumarianou A (ref4) 2015; 7
Khoo CY (ref15) 2018; 44
Sakabe T (ref5) 2017; 13
Hornick JL (ref16)
Mulet-Margalef N (ref9) 2016; 9
Ahmed M (ref12) 2020; 8
Parab TM (ref8) 2019; 10
References_xml – volume: 62
  year: 2017
  ident: ref6
  article-title: Stem cell factor/KIT signal insufficiency contributes to hypoxia-induced intestinal motility dysfunctions in neonatal mice
  publication-title: Dig Dis Sci
  doi: 10.1007/s10620-017-4533-y
  contributor:
    fullname: Ren H
– ident: ref1
– volume: 372
  year: 2021
  ident: ref14
  article-title: The PRISMA 2020 statement: an updated guideline for reporting systematic reviews
  publication-title: BMJ
  doi: 10.1136/bmj.n71
  contributor:
    fullname: Page MJ
– volume: 13
  year: 2017
  ident: ref5
  article-title: CD117 expression is a predictive marker for poor prognosis in patients with non-small cell lung cancer
  publication-title: Oncol Lett
  doi: 10.3892/ol.2017.5925
  contributor:
    fullname: Sakabe T
– ident: ref7
– ident: ref16
  article-title: Practical Soft Tissue Pathology: A Diagnostic Approach
  contributor:
    fullname: Hornick JL
– volume: 7
  year: 2015
  ident: ref4
  article-title: Gastrointestinal stromal tumors (GIST): a prospective analysis and an update on biomarkers and current treatment concepts
  publication-title: Biomark Cancer
  doi: 10.4137/BIC.S25045
  contributor:
    fullname: Koumarianou A
– volume: 120
  year: 2019
  ident: ref11
  article-title: Secondary KIT mutations: the GIST of drug resistance and sensitivity
  publication-title: Br J Cancer
  doi: 10.1038/s41416-019-0388-7
  contributor:
    fullname: Napolitano A
– volume: 11
  year: 2020
  ident: ref3
  article-title: Na+/Ca2 + exchange and pacemaker activity of interstitial cells of Cajal
  publication-title: Front Physiol
  doi: 10.3389/fphys.2020.00230
  contributor:
    fullname: Zheng H
– volume: 8
  year: 2020
  ident: ref12
  article-title: Recent advances in the management of gastrointestinal stromal tumor
  publication-title: World J Clin Cases
  doi: 10.12998/wjcc.v8.i15.3142
  contributor:
    fullname: Ahmed M
– volume: 14
  year: 2021
  ident: ref13
  article-title: The management of metastatic GIST: current standard and investigational therapeutics
  publication-title: J Hematol Oncol
  doi: 10.1186/s13045-020-01026-6
  contributor:
    fullname: Kelly CM
– volume: 44
  year: 2018
  ident: ref15
  article-title: Systematic review of current prognostication systems for primary gastrointestinal stromal tumors
  publication-title: Eur J Surg Oncol
  doi: 10.1016/j.ejso.2017.12.006
  contributor:
    fullname: Khoo CY
– volume: 9
  year: 2016
  ident: ref9
  article-title: Sunitinib in the treatment of gastrointestinal stromal tumor: patient selection and perspectives
  publication-title: Onco Targets Ther
  doi: 10.2147/OTT.S101385
  contributor:
    fullname: Mulet-Margalef N
– volume: 10
  year: 2018
  ident: ref10
  article-title: Management of hemorrhage in gastrointestinal stromal tumors: a review
  publication-title: Cancer Manag Res
  doi: 10.2147/CMAR.S159689
  contributor:
    fullname: Liu Q
– volume: 23
  year: 2016
  ident: ref2
  article-title: Small bowel GIST: clinical presentation as intussusception and obscure bleeding
  publication-title: GE Port J Gastroenterol
  doi: 10.1016/j.jpge.2015.12.007
  contributor:
    fullname: Giestas S
– volume: 10
  year: 2019
  ident: ref8
  article-title: Gastrointestinal stromal tumors: a comprehensive review
  publication-title: J Gastrointest Oncol
  doi: 10.21037/jgo.2018.08.20
  contributor:
    fullname: Parab TM
– volume: 10
  year: 2016
  ident: ref17
  article-title: Can individualized sunitinib dose and schedule changes optimize outcomes for kidney cancer patients?
  publication-title: Can Urol Assoc J
  doi: 10.5489/cuaj.4293
  contributor:
    fullname: Bjarnason GA
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Snippet Gastrointestinal stromal tumors (GISTs) are soft-tissue sarcomas that can occur anywhere in the digestive tract, with the stomach and small intestine being the...
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StartPage e26848
SubjectTerms Ablation
Cancer
Drug therapy
Endoscopy
Gastrointestinal cancer
Growth factors
Inhibitor drugs
Internal Medicine
Intestinal obstruction
Keywords
Medical prognosis
Metastasis
Mutation
Oncology
Patients
Radiation therapy
Sarcoma
Small intestine
Surgery
Systematic review
Targeted cancer therapy
Therapeutics
Tumors
Ultrasonic imaging
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Title Evaluation of and Current Trends in the Management of Gastrointestinal Stromal Tumors: A Systematic Review
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