How the GIST Treatment Landscape is Evolving For Patients

The gastrointestinal stromal tumor (GIST) treatment landscape has shifted in recent years due to the emergence of new therapies, many of which patients should 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,” Dr. Rosario Ligresti explained.

Ligresti is the chief of Gastroenterology and Interventional Endoscopy at Hackensack Meridian Health, and he sat down for an interview with CURE to delve into the topic.

Transcript

How has the treatment landscape for GIST changed in recent years? What new therapies or advances should patients with GIST be aware of?

Among all the gastrointestinal tumors out there, I think this is probably emblematic of the way oncology is going. We talk about precision-guided therapy and precision medicine very often in oncology, but the pathological changes that occur in GISTs symbolize that entire field.

GISTs are very unique tumors in that they start and are driven by one of three specific genetic mutations in a patient's genes. When you have one of these mutations, it can cause these tumors to either grow more or less significantly. The way therapy has changed is that when you have these mutations, you can target them with specific medications.

Originally, when GISTs were first described, the only option for patients was surgery, which remains a very important option. You see the tumor, and you remove it. If patients are presenting with obstruction, bleeding, ulceration or trouble swallowing, removing the tumor is still critical.

However, if the tumor has been diagnosed when the patient already has advanced disease or if it has spread outside of the intestinal tract, that's when you start talking about giving patients medical therapy or chemotherapy. The chemotherapy used for these patients is very different from the standard chemotherapy for other intestinal tumors, such as adenocarcinomas, colon cancers, or stomach cancers. These are medications used specifically to block a certain genetic product that these tumors make because of genetic mutations within the tumor.

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.

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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