How is GIST treated?

Until the approval of oral therapies, patients with KIT+ GIST had few treatment options. Traditional cancer therapies—such as chemotherapy and radiation—are not very effective in treating the disease.

Surgery to remove the tumor (surgical resection) remains the primary treatment for the management of GIST. However, some GISTs cannot be surgically removed because they are too large or because they have already metastasized (spread to another part of the body). Often, even with surgery, parts of the original GIST remain or the GIST returns to another site in the body. This is referred to as recurrence.

What is the primary goal of oral treatments for GIST?

The primary goal of oral treatments for GIST is to block the abnormal KIT protein that causes cancer cells to keep growing. These medicines (called tyrosine kinase inhibitors or TKIs) work in GIST by "turning off" the signal from the KIT protein so that GIST cells should stop growing. TKIs are now accepted as effective medicines for KIT+ GIST .

What can a patient do to help GIST treatment succeed?

GIST treatment can be helped by taking the GIST medication as directed by the healthcare professional. Even if you have no symptoms or feel fine, taking the medication every day as prescribed is essential. It is important to remember that KIT+ GIST is caused by an abnormal KIT protein that has its signals "turned on" all the time. If you stop taking the medication that blocks the KIT protein, the KIT protein can turn back "on." The abnormal cells can then start growing again.

Also, patients and caregivers can help treatment success by taking advantage of support programs and available advice that can help you set up a daily routine that makes it easier to remember to take your GIST therapy. Patients with GIST often stay on treatment for an extended period of time, so it may be helpful to schedule taking your medication along with other things that are part of your daily routine. Patients/caregivers should be sure to discuss dosing routine with the healthcare professional.

Why is it important to maintain GIST treatment?

While surgery can remove tumors, KIT+ GISTs often come back. When a patient undergoes surgery to remove GIST (primary tumors or metastases), some tumor cells can remain. GIST can return. Healthcare professionals refer to this as recurrence.

Even if a GIST has been completely removed, it has a high chance of coming back. In fact, between 40% and 50% of patients with completely resected primary GIST will develop recurrent or metastatic disease within 2 years.* A healthcare professional may prescribe a daily medication, even if the tumor was completely removed, to help minimize GIST recurrence.

It is important to remember that KIT+ GIST is caused by an abnormal KIT protein that has its signals turned "on" all the time. If you stop taking the medication that blocks the KIT protein, then the KIT protein can turn back "on." The abnormal cells can then start growing again.

¹ Median follow-up (range, 1-175 months).

Do the available oral treatments for GIST cure the patient of the disease?

No. The 2 oral medications currently approved by the FDA for unresectable (inoperable) and/or metastatic GIST are used to treat gastrointestinal stromal tumors. The medications work by blocking, or turning off, the abnormal KIT protein in cancer cells that cause the cancer cells to grow and multiply. If you stop taking the medication that blocks the KIT protein, then the KIT protein can turn back "on." The abnormal cells can then start growing again.

What kinds of tests might a doctor order when evaluating and treating GIST?

A healthcare professional could order several tests when evaluating and/or treating GIST. Patients/caregivers should speak to the healthcare professional team to learn more about the tests and how they are used to monitor GIST and GIST treatment.