Advanced gastrointestinal stromal tumor in Europe: a review of updated treatment recommendations

The European Society for Medical Oncology (ESMO) recommendations on the management of gastrointestinal stromal tumor (GIST) have recently been updated. Imatinib 400 mg/day remains the standard first-line treatment for patients with metastatic GIST. Mutational analysis has received a strong recommendation for diagnostic purposes. Furthermore, patients with KIT exon 9-activating mutations are now recommended to receive imatinib 800 mg/day as first-line treatment. Following progression during treatment with imatinib 400 mg/day, increasing the imatinib dose to 800 mg/day is advised. In the case of further progression or intolerance to imatinib, sunitinib 50 mg/day (schedule 4/2) is recommended. This article reviews the evidence underlying the updates to the ESMO recommendations on the management of GIST and discusses the implications of the changes.