director of Sarcoma Medical Oncology at the University of Colorado Cancer Center.

Dr. Breelyn Wilky 

Dr. Breelyn Wilky stresses the importance of expert guidance and second opinions for patients with GIST, as treatment options continue to evolve rapidly.

GIST Expert Urges Patients to Seek Specialized Second Opinions

Dr. Breelyn Wilky, director of sarcoma medical oncology at the University of Colorado Cancer Center, encourages patients with gastrointestinal stromal tumors (GIST) to seek expert care and stay informed.

With research advancing rapidly and new treatments emerging, she says it’s crucial to get a second opinion from a specialist experienced in GIST. This can help patients better understand their current and future options, as well as potential clinical trials. Because the GIST landscape is evolving quickly, Wilky emphasizes the value of partnering with a provider who is actively engaged in the latest research and developments in the field.

Wilky also serves as the director of Sarcoma Medical Oncology, deputy associate director for Clinical Research, and the Cheryl Bennett and McNeilly Family Endowed Chair in Sarcoma Research at the University of Colorado Cancer Center, UCHealth.

What are the biggest advances in GIST treatment right now? What should patients know?

: The key thing for patients to know, especially as we're talking about just awareness day, is to get educated. Learn about your disease and the research that's being done. There is more research being done, and more new therapies are being developed. The research, understanding, and our tools and expertise are so much better for GIST than most of our other sarcoma types. Therefore, it's worth making sure you get a second opinion or see a provider who really has a lot of experience with GIST.

You don't have to stay there forever, but at least get that initial opinion, have your whole case reviewed, and get educated about your current treatment options, what they might be in the future, and any considerations for your particular tumor that you need to know about. This changes therapy, and there's so much movement in this research space. It's impossible, or at least very, very difficult, for patients to navigate some of the databases out there; even doctors sometimes have trouble finding every clinical trial on clinicaltrials.gov.

The key thing is to see a GIST specialist who has been in these circles, who has gone to the meetings and heard from the companies that are developing these latest and greatest drugs. Get yourself an expert in your corner.

Transcript has been edited for clarity and conciseness.

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Dr. Breelyn Wilky explains that personalized treatments are helping improve outcomes for patients with gastrointestinal stromal tumors.

Personalized Therapy Helps Tailor Treatment for GIST, Expert Explains

Personalized treatment is helping improve outcomes for patients with gastrointestinal stromal tumors (GIST), as explained by Dr. Breelyn Wilky, director of sarcoma medical oncology at the University of Colorado Cancer Center.

Wilky emphasized that no two cases of GIST are exactly alike, even though it’s the most common type of soft-tissue sarcoma. “I describe my patients as snowflakes,” she said, meaning that everyone’s cancer is slightly different. These differences can influence both prognosis and treatment.

Factors like tumor size, location and growth rate help guide early treatment decisions, Wilky noted. Genetic mutation testing plays a key role as well, since around 80% of patients with GIST have mutations at diagnosis that activate a protein called KIT. Even within that group, subtle differences in mutations can affect how a tumor responds to certain drugs.

Wilky encouraged patients to talk with their care teams about their mutation reports to better understand which treatments may work best for their individual cancer.

How is personalized therapy changing the outlook for people living with GIST?

The key thing for patients is to recognize that even though you have GIST, the most common [sarcoma] tumor, everybody’s a little bit different. I describe my patients as snowflakes. While you may all be snowy and shaped prettily and all those things, everyone’s a little bit different. And that’s super, super important, and we’re only learning more about how important it is as we start to think about prognosis and treatments.

Some of the factors that play into this and how you’re going to do — how your disease will behave, what therapies might be good for you — some of it comes down to simple things like how big your tumor was, where it was located along the GI tract, or how quickly it was growing — what we call the mitotic rate. Those are some of the early things we use to establish these risk scores and predict things.

But then the role of mutation testing — so again, figuring out where in your GIST cell did the mutation happen. As I mentioned, 80% of patients have an activated or flipped-on switch for KIT, and 80% of those have the same sort of spot where the mutation is likely to happen. Even within that, there are subtle differences. Getting your mutation report, talking about that with your doctors, understanding what your treatment options are — is there any evidence that certain drugs might work better for your particular tumor than others? Those are the questions that you want to be asking.

Dr. Breelyn Wilky

GIST Expert Urges Patients to Seek Specialized Second Opinions

Personalized Therapy Helps Tailor Treatment for GIST

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