Dr. Van Tine on Sequencing Therapies in GIST

Brian A. Van Tine, MD, PhD, assistant professor of medicine, Division of Oncology, Section of Medical Oncology, Washington University School of Medicine, discusses sequencing in gastrointestinal stromal tumors (GIST).

As knowledge of GIST has grown and the field has entered a more molecular era, Van Tine is supportive of sequencing all patients with GIST, since 10% to 15% of them lack either a mutation in KIT or PDGF. Some of these known mutations have a unique biology, Van Tine explains, so treating the disease with imatinib no longer applies to all patients. Some of these mutations may be imatinib-resistant.

Moreover, 1 in 10 patients with GIST may also have wild-type GIST; however, they may have SDH deficiency, which encompasses an entirely different biology. These patients should have a different treatment plan.

GIST should be evolved into a more well-defined disease with therapies for specific mutations for multiple line settings, similar to other cancer types, Van Tine explains. Patients with GIST should speak with their oncologists regarding a personalized treatment plan for their mutation type.