Considering the role of radiation therapy for gastrointestinal stromal tumor

Corbin, Kimberly S.; Kindler, Hedy L.; Liauw, Stanley L.

doi:10.2147/ott.s36873

Cited by 17 publications

(10 citation statements)

References 53 publications

(63 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Randomized clinical trials showed increased rates of recurrence in patients when IM is discontinued. This led to the belief that IM has a “cytostatic” activity [44]. Therefore, patients will have to remain on IM therapy for long periods of time to delay recurrence.…”

Section: Introductionmentioning

confidence: 99%

Beyond standard therapy: drugs under investigation for the treatment of gastrointestinal stromal tumor

Alturkmani

Pessetto

Godwin

2015

Expert Opinion on Investigational Drugs

View full text Add to dashboard Cite

Introduction Gastrointestinal stromal tumor (GIST) is the most common non-epithelial malignancy of the GI tract. With the discovery of KIT and later PDGFRA gain-of-function mutations as factors in the pathogenesis of the disease, GIST was the quintessential model for targeted therapy. Despite the successful clinical use of imatinib mesylate, a selective receptor tyrosine kinase (RTK) inhibitor that targets KIT, PDGFRA and BCR-ABL, we still do not have treatment for the long-term control of advanced GIST. Areas covered This review summarizes the drugs that are under investigation or have been assessed in trials for GIST treatment. The article focuses on their mechanisms of actions, the preclinical evidence of efficacy, and the clinical trials concerning safety and efficacy in humans. Expert opinion It is known that KIT and PDGFRA mutations in GIST patients influence the response to treatment. This observation should be taken into consideration when investigating new drugs. RECIST was developed to help uniformly report efficacy trials in oncology. Despite the usefulness of this system, many questions are being addressed about its validity in evaluating the true efficacy of drugs knowing that new targeted therapies do not affect the tumor size as much as they halt progression and prolong survival.

show abstract

Section: Introductionmentioning

confidence: 99%

Beyond standard therapy: drugs under investigation for the treatment of gastrointestinal stromal tumor

Alturkmani

Pessetto

Godwin

2015

Expert Opinion on Investigational Drugs

View full text Add to dashboard Cite

show abstract

“…Though long considered radioresistant, GIST metastases can be effectively palliated by RT [ 85 – 87 ]. In a prospective study of 25 patients with TKI-refractory GIST, 80% had stability of target lesions lasting a median of 16 months and median OS was 19 months [ 87 ].…”

Section: Locoregional Therapy For Metastatic Diseasementioning

confidence: 99%

Contemporary Management of Metastatic Gastrointestinal Stromal Tumors: Systemic and Locoregional Approaches

Ang

Maki

2016

Oncol Ther

View full text Add to dashboard Cite

The treatment of metastatic gastrointestinal stromal tumors (GISTs) changed dramatically with the introduction of imatinib into the therapeutic lexicon in 2001. Over the past 15 years, tyrosine kinase inhibitors in the adjuvant and metastatic settings have remained the standard of care for this disease, though alternate classes of agents and new therapeutic targets are being actively explored in clinical trials. Although data are limited, the use of surgical and non-surgical locoregional techniques for the treatment of GIST metastases has increased and given reports of promising and durable responses. Herein we provide an overview of the contemporary therapeutic landscape of metastatic GIST.

show abstract

“…Currently, GISTs are typically treated with resection and adjuvant therapy with tyrosine kinase inhibitors (TKIs) at high risk for recurrence (4,5). Unresectable or metastatic tumors are treated primarily by TKIs therapy (6,7). Under the current treatment guidelines, radiotherapy is not a recommended option, or is only used for palliative intent of bone metastases (8).…”

Section: Introductionmentioning

confidence: 99%

“…However, radiotherapy for GISTs was still limited to dose-limiting toxicity of the adjacent small bowel. In recent years, intensity-modulated radiation therapy (IMRT), image-guided radiation therapy (IGRT) and other technological advances has realized dose escalation in target volume and potential reduction in acute and delayed toxicity by facilitating treatment delivery and normal tissue protection (6). Moreover, simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) can deliver the highest possible dose to target volume and increase tumor response without significant increase of healthy tissue irradiation (16,17).…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Integrated Boost Intensity-Modulated Radiotherapy for Locally Advanced Drug-Resistant Gastrointestinal Stromal Tumors: A Feasibility Study

Cui

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

BackgroundAs an emerging clinical problem, locally advanced drug-resistant gastrointestinal stromal tumors (LADRGISTs) has relatively few therapeutic schemes. Although radiotherapy is not often considered for GISTs, it could be a valuable contributing modality. The aim of our study is to explore a safe and effective radiation regimen for LADR-GISTs.MethodsThree patients with LADR-GISTs were treated with simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) plans. In the SIB-IMRT plans, gross target volume (GTV) was divided into GTV-outer, GTV-mid, and GTV-center. And the prescribed dose of planning gross target volume (PGTV) and GTV-outer were both set to 50.4 Gy in 28 fractions. GTV-mid and GTV-center were simultaneously boosted to 60–62 Gy and 62–64 Gy respectively. For comparison purposes, conventional IMRT (Con-IMRT) plans with uniform dose distribution were generated for same optimization objectives without a dose boost to GTV-mid and GTV-center. All plans were optimized to make sure that deliver at least 95% of the prescription dose was delivered to PGTV. Isodose distribution, dose profiles, conformity indexes (CIs), monitor units (MUs), and dose volume histogram (DVH) was evaluated for each individual patient. After the three patients were treated with SIB-IMRT plans, the relative changes in the tumor size and CT values by CT scanning were also tracked.ResultsCompared with Con-IMRT plans, SIB-IMRT plans saw a significant increase from D95 to D2 of the GTV. With steeper dose gradients in the dose profiles, SIB-IMRT plans had GTV-mid and GTV-center accumulated with higher dose mainly by delivering extra 93 MUs in average. However, there was no significant difference in CIs and organs at risks (OARs) DVH. The relative changes in tumor size and CT values of the three patients in follow up were up to the Choi criteria and the three patients were all assessed as partial response.ConclusionsThe proposed SIB-IMRT may be a potential technique for achieving objective response and prolonging survival of selected GISTs patients.

show abstract

Considering the role of radiation therapy for gastrointestinal stromal tumor

Cited by 17 publications

References 53 publications

Beyond standard therapy: drugs under investigation for the treatment of gastrointestinal stromal tumor

Beyond standard therapy: drugs under investigation for the treatment of gastrointestinal stromal tumor

Contemporary Management of Metastatic Gastrointestinal Stromal Tumors: Systemic and Locoregional Approaches

Simultaneous Integrated Boost Intensity-Modulated Radiotherapy for Locally Advanced Drug-Resistant Gastrointestinal Stromal Tumors: A Feasibility Study

Contact Info

Product

Resources

About