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| Management of malignant gastrointestinal stromal tumours |
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| Author(s): Joensuu H, Fletcher C, Dimitrijevic S, Silberman S, Roberts P, Demetri G |
| Source: LANCET ONCOLOGY Volume: 3 Issue: 11 Pages: 655-664 Published: NOV 2002 |
| Times Cited: 197 References: 80 |
| Abstract: Gastrointestinal stromal tumours (GISTs) are the most common form of mesenchymal tumour of the gastrointestinal tract. Clinically, they range from small indolent tumours curable with surgery alone to aggressive cancers. Making a distinction between an indolent and a malignant GIST is unreliable with conventional histopathological techniques. The presence of metastases at the time of diagnosis confirms malignancy, but all GISTs should be regarded as having malignant potential. GISTs characteristically express the KIT protein, a transmembrane tyrosine kinase receptor for stem-cell factor. Most GISTs have a mutation in the KIT proto-oncogene that translates into a gain-of-function constitutive activation of the KIT kinase. KIT activation seems to be an early tumour-promoting event in pathogenesis. Commonly, malignant GISTs show high-level primary resistance to conventional chemotherapy. Imatinib mesylate is an orally administered selective inhibitor of certain tyrosine kinases including KIT. Most patients with advanced malignant GISTs achieve clinical benefit and significant antitumour responses with imatinib mesylate. Responses have been durable, and most patients tolerate the drug well at clinically effective doses. Imatinib mesylate is the first effective systemic therapy for advanced GIST. |
| Document Type: Review |
| Language: English |
| Reprint Address: Joensuu, H (reprint author), Univ Helsinki, Cent Hosp, Dept Oncol, Haartmaninkatu 4,POB 180, FIN-00029 Helsinki, Finland |
Addresses:
1. Univ Helsinki, Cent Hosp, Dept Radiotherapy & Oncol, Helsinki, Finland
2. Brigham & Womens Hosp, Dept Pathol, Boston, MA 02115 USA
3. Harvard Univ, Sch Med, Cambridge, MA 02138 USA
4. Novortis Oncol, Basel, Switzerland
5. Turku Univ, Cent Hosp, Dept Surg, FIN-20520 Turku, Finland
6. Dana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Dept Med Oncol, Boston, MA 02115 USA |
| Publisher: LANCET LTD, 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND |
| Subject Category: Oncology |
| IDS Number: 612QK |
| ISSN: 1470-2045 |
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