Breaking Down the Treatment of GIST for Patients

In an interview with CURE, Dr. Rosario Ligresti, the chief of Gastroenterology and Interventional Endoscopy at Hackensack Meridian Health, highlighted what patients with gastrointestinal stromal tumors (GIST) should know upon starting treatment.

He shared new advancements in treatment, discussed the most effective ways patients can manage treatment-related side effects, and noted how patients can stay well-informed about their disease.

Tune in to our earlier conversation with Ligresti where he discussed the common signs and symptoms of GIST, as well as explained how the treatment landscape has changed for patients.

CURE: What new therapies or advances should patients with GIST be aware of?

The most important thing you can do for these patients when you first see them is to perform mutational profiling. You take a piece of the tumor tissue and look for these specific gene mutations. Why does this matter? Because it really helps you pick which medication will be most effective for these tumors. This is what has really changed in this field, and it's emblematic of all of oncology now.

We are being very precise about the mutation that the patient's tumor has, whereas in the past, treatment was very broad-spectrum and generic. This is now targeted specifically to the tumor that the patient has.

What are the most effective ways patients living with GIST can manage treatment-related side effects and maintain their quality of life during therapy?

A lot will depend on where the tumor is located. For example, if there's a very large tumor in the stomach and the patient's presenting symptoms are abdominal pain and bleeding, the treatment is very often done locally at the tumor site. Patients can have surgery, a kind of localized surgery, whether it's laparoscopic or robotic, to remove the piece of the stomach that has the tumor. This gives patients immediate relief.

If patients have a disease that can't be readily treated surgically, you can theoretically use some ablation therapy, which is a kind of endoscopically driven needle therapy. You can also do embolization therapies. Ultimately, we talk about using these oncologic therapies for disease that is outside of one particular area, all of which matters a lot because these tumors have a lot of local side effects. You can achieve a lot of local control for patients, and the symptoms driven by those local side effects can be palliated or even treated very effectively.

Again, the bigger problem is when these tumors have spread substantially, but that's where those medications really do help. Among all the GI tumors I see, these probably respond the quickest and the best to these kinds of therapies. Once you target that molecular switch in these tumors, they often stop growing very, very rapidly, and sometimes they regress dramatically. So, you'll take a patient who has a lot of bulky disease and give them some of these medications (there are three that are FDA-approved now) and these tumors just stop dead in their tracks. They are very, very dependent on these molecular alterations for growth.

Again, there are a lot of options in the armamentarium of the oncologist and the gastroenterologist to offer patients. It's one of those tumors where you're not happy to see it, but at the same time, if someone is going to have a stomach tumor, you'd rather it be this one because there are actually very effective therapies for it.

What guidance can you offer patients newly diagnosed with GIST on accessing support resources, seeking second opinions, and staying well-informed about their care?

The good thing is that there are some very good support groups for this. It's not common to find support groups for every rare tumor, but GIST and other rare tumors certainly have support groups available.

One of these support groups is called GIST Together, a grassroots group of very important advocates for patients with this disease. I'm amazed at how much information they can offer patients, as well as general support. Their website is full of information about side-effect management, available treatment options, and even links to cutting-edge trials for this disease.

There are certainly support resources available. Obviously, this all stems back to having a very good rapport with your oncologist and gastroenterologist so they can guide you through everything. The therapy is generally very prolonged, so you want to have a very good relationship with your treatment team and a good cancer center.

Again, keep in mind that these are very uncommon tumors that are best treated by people who see a lot of them. These are not your average oncology tumors. Having said that, expertise matters, and for these particular tumors, which are so uncommon, you want to go to the people who see a lot of them.

Reference

1. “Expert Oncologist Breaks Down the Current Treatment Landscape of GIST,” by Ryan Scott. CURE, August 19, 2025; https://www.curetoday.com/view/expert-oncologist-breaks-down-the-current-treatment-landscape-of-gist

Transcript has been edited for clarity and conciseness.

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