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Gastrointestinal Stromal Tumors Medication

  • Author: Nancy S Behazin, MD; Chief Editor: BS Anand, MD  more...
Updated: Mar 30, 2015

Medication Summary

Imatinib mesylate is the only available drug that has made a significant impact in the treatment of GISTs.


Antineoplastics, Tyrosine Kinase Inhibitor

Class Summary

Imatinib mesylate (STI 571) is a selective tyrosine kinase inhibitor with action against mutant c-Kit as occurs in association with GISTs. It represents a breakthrough in antineoplastic drug therapy because it is targeted against a specific molecular derangement.

In 1996, Druker et al were the first to report this effect in laboratory experiments.[39] In 2001, Druker, Talpaz, and coworkers reported the results of clinical trials demonstrating >90% complete clinical response rates.[40]

Following the Hirota et al 1998 landmark report of the role of c-kit proto-oncogene mutations in the pathogenesis of GISTs, involving activation of KIT tyrosine kinase, it was hypothesized that KIT inhibition might be a successful treatment strategy for GISTs. Druker et al in 1996, Buchdunger et al in 1996, and Heinrich et al in 2000 indeed demonstrated such activity in the laboratory in various cell lines.[39, 41, 42] In 2001, Tuveson et al proved in vivo efficacy against human GIST cells, showing that STI-571 produced cell cycle arrest and apoptosis.[43]

Clinical trials with imatinib quickly followed. In 2001, Blanke et al reported preliminary results using imatinib in 145 subjects. No complete responses were observed.[44] The partial clinical response rate was 59%, and 13% of the group had progression of disease while receiving imatinib doses of 400-600 mg/d.

In 2002, van Oosterom et al published their results from 35 patients with GISTs receiving imatinib doses of 400-1000 mg/d.[45] Partial responses were achieved in 54%, and disease remained stable in an additional 37%. The most common adverse effects were periorbital edema (40%), peripheral edema (37%), fatigue (30%), rash (30%), and nausea and vomiting (25%). Late severe myelosuppression was uncommon. The highest well-tolerated dose in this study was 400 mg bid. At doses of 500 mg bid, severe nausea, vomiting, edema, and rashes were common. After a minimum follow-up of 10 mo, 82% of subjects continued to have a partial disease response (51%) or no evidence of disease progression (31%).

Rink et al studied gene expression using oligonucleotide microarrays on tumor samples obtained before and after imatinib mesylate therapy.[46] Thirty-eight genes were expressed at significantly lower levels in the pretreatment biopsy samples from tumors that significantly responded to 8-12 weeks of imatinib mesylate, that is, >25% tumor reduction. Eighteen of these genes encoded Krüppel-associated box (KRAB) domain containing zinc finger (ZNF) transcriptional repressors. Ten KRAB-ZNF genes mapped to a single locus on chromosome 19p, and a subset predicted likely response to imatinib mesylate-based therapy in a naïve panel of GIST. This gene signature that includes KRAB-ZNF 91 subfamily members that may be both predictive of and functionally associated with likely response to short-term imatinib mesylate treatment.

Imatinib (Gleevec R)


Also known as STI-571, imatinib first received attention as an inhibitor of the BCR-ABL fusion protein, which induces uncontrolled tyrosine kinase activity in CML.

Sunitinib (Sutent)


Sunitinib is a multikinase inhibitor that targets several tyrosine kinase inhibitors implicated in tumor growth, pathologic angiogenesis, and metastatic progression. It inhibits platelet-derived growth factor receptors (ie, PDGFR-alpha, PDGFR-beta), vascular endothelial growth factor receptors (ie, VEGFR1, VEGFR2, VEGFR3), stem cell factor receptor (KIT), Fms-like tyrosine kinase-3 (FLT3), colony-stimulating factor receptor type 1 (CSF-1R), and the glial cell-line–derived neurotrophic factor receptor (RET).

It is indicated for persons with gastrointestinal stromal tumors (GISTs) whose disease has progressed or who are unable to tolerate treatment with imatinib (Gleevec). It delays the median time to tumor progression.

Regorafenib (Stivarga)


Regorafenib is a tyrosine kinase inhibitor. It is indicated for locally advanced, unresectable gastrointestinal stromal tumors that no longer respond to other treatments (eg, imatinib, sunitinib).

Contributor Information and Disclosures

Nancy S Behazin, MD Fellow, Department of Gastroenterology, Scott and White Hospital, Texas A&M Health Science Center College of Medicine

Nancy S Behazin, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Medical Association, American Society for Gastrointestinal Endoscopy, Texas Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Noel Williams, MD, FRCPC FACP, MACG, Professor Emeritus, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Professor, Department of Internal Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada

Noel Williams, MD, FRCPC is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Chief Editor

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.


Robert A Decker, MD Clinical Assistant Professor, Department of Medicine, University of Hawaii at Manoa: Chief, Gastroenterology Service, Kaiser Permanente Medical Center of Honolulu

Disclosure: Nothing to disclose.

Sandeep Mukherjee, MB, BCh, MPH, FRCPC Associate Professor, Department of Internal Medicine, Section of Gastroenterology and Hepatology, University of Nebraska Medical Center; Consulting Staff, Section of Gastroenterology and Hepatology, Veteran Affairs Medical Center

Sandeep Mukherjee, MB, BCh, MPH, FRCPC is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Merck Honoraria Speaking and teaching; Ikaria Pharmaceuticals Honoraria Board membership

Michael AJ Sawyer, MD Consulting Staff, Department of Surgery, Southwestern Medical Center; Consulting Staff, Department of Surgery, Comanche County Memorial Hospital; Consulting Staff, Great Plains Surgical Clinic, Inc

Michael AJ Sawyer, MD is a member of the following medical societies: American College of Surgeons, Society for Surgery of the Alimentary Tract, Society of American Gastrointestinal and Endoscopic Surgeons, and Society of Laparoendoscopic Surgeons

Disclosure: Nothing to disclose.

  1. Cheung MC, Zhuge Y, Yang R, Koniaris LG. Disappearance of racial disparities in gastrointestinal stromal tumor outcomes. J Am Coll Surg. 2009 Jul. 209(1):7-16. [Medline].

  2. Tran T, Davila JA, El-Serag HB. The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000. Am J Gastroenterol. 2005 Jan. 100(1):162-8. [Medline].

  3. Miettinen M, Makhlouf H, Sobin LH, Lasota J. Gastrointestinal stromal tumors of the jejunum and ileum: a clinicopathologic, immunohistochemical, and molecular genetic study of 906 cases before imatinib with long-term follow-up. Am J Surg Pathol. 2006 Apr. 30(4):477-89. [Medline].

  4. Nilsson B, Bumming P, Meis-Kindblom JM, Oden A, Dortok A, Gustavsson B. Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era--a population-based study in western Sweden. Cancer. 2005 Feb 15. 103(4):821-9. [Medline].

  5. Heinrich MC, Corless CL, Demetri GD, et al. Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. J Clin Oncol. 2003 Dec 1. 21(23):4342-9. [Medline].

  6. Ghanem N, Altehoefer C, Furtwangler A, et al. Computed tomography in gastrointestinal stromal tumors. Eur Radiol. 2003 Jul. 13(7):1669-78. [Medline].

  7. Zhou HY, Zhang XM, Zeng NL, Jian SH, Tang W. Use of conventional MR imaging and diffusion-weighted imaging for evaluating the risk grade of gastrointestinal stromal tumors. J Magn Reson Imaging. 2012 Dec. 36(6):1395-401. [Medline].

  8. Tateishi U, Hasegawa T, Satake M, Moriyama N. Gastrointestinal stromal tumor. Correlation of computed tomography findings with tumor grade and mortality. J Comput Assist Tomogr. 2003 Sep-Oct. 27(5):792-8. [Medline].

  9. Shojaku H, Futatsuya R, Seto H, Tajika S, Matsunou H. Malignant gastrointestinal stromal tumor of the small intestine: radiologic-pathologic correlation. Radiat Med. 1997 May-Jun. 15(3):189-92. [Medline].

  10. Zhao X, Yue C. Gastrointestinal stromal tumor. J Gastrointest Oncol. 2012 Sep. 3(3):189-208. [Medline]. [Full Text].

  11. Kindblom LG, Remotti HE, Aldenborg F, Meis-Kindblom JM. Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. Am J Pathol. 1998 May. 152(5):1259-69. [Medline]. [Full Text].

  12. Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998 Jan 23. 279(5350):577-80. [Medline].

  13. Miettinen M, Sobin LH, Lasota J. Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol. 2005 Jan. 29(1):52-68. [Medline].

  14. Yamashita F, Sasatomi E, Kiyama M, et al. Radiographic observation of a case of gastrointestinal stromal tumor in stomach. Kurume Med J. 2001. 48(3):233-6. [Medline].

  15. Stroobants S, Goeminne J, Seegers M, et al. 18FDG-Positron emission tomography for the early prediction of response in advanced soft tissue sarcoma treated with imatinib mesylate (Glivec). Eur J Cancer. 2003 Sep. 39(14):2012-20. [Medline].

  16. Pidhorecky I, Cheney RT, Kraybill WG, Gibbs JF. Gastrointestinal stromal tumors: current diagnosis, biologic behavior, and management. Ann Surg Oncol. 2000 Oct. 7(9):705-12. [Medline].

  17. Chak A, Canto MI, Rosch T, et al. Endosonographic differentiation of benign and malignant stromal cell tumors. Gastrointest Endosc. 1997 Jun. 45(6):468-73. [Medline].

  18. Belloni M, De Fiori E, Mazzarol G, Curti A, Crosta C. Endoscopic ultrasound and Computed Tomography in gastric stromal tumours. Radiol Med. 2002 Jan-Feb. 103(1-2):65-73. [Medline].

  19. Kim GH, Park do Y, et al. Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?. World J Gastroenterol. 2009 Jul 21. 15(27):3376-81. [Medline]. [Full Text].

  20. Gordon BM, Herlong J, Uflacker R, Gordon L. Recurrent lower gastrointestinal hemorrhage: ileal neoplasm diagnosed by scintigraphy with Tc 99m red blood cells and angiography. South Med J. 1996 Dec. 89(12):1204-7. [Medline].

  21. Au VW, Peh WC. Clinics in diagnostic imaging (16). Lower gastrointestinal bleeding caused by ileal tumour. Singapore Med J. 1996 Aug. 37(4):434-7. [Medline].

  22. Nakagawa M, Akasaka Y, Kanai T, et al. Extragastrointestinal stromal tumor of the greater omentum: case report and review of the literature. Hepatogastroenterology. 2003 May-Jun. 50(51):691-5. [Medline].

  23. Suzuki K, Kaneko G, Kubota K, et al. Malignant tumor, of the gastrointestinal stromal tumor type, in the greater omentum. J Gastroenterol. 2003. 38(10):985-8. [Medline].

  24. Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol. 2002 May. 33(5):459-65. [Medline].

  25. Koh Y, Lee HE, Oh DY, et al. The lack of CD34 expression in gastrointestinal stromal tumors is related to cystic degeneration following imatinib use. Jpn J Clin Oncol. 2012 Nov. 42(11):1020-7. [Medline].

  26. Woodall CE 3rd, Brock GN, Fan J, et al. An evaluation of 2537 gastrointestinal stromal tumors for a proposed clinical staging system. Arch Surg. 2009 Jul. 144(7):670-8. [Medline].

  27. Demetri GD, von Mehren M, Blanke CD, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med. 2002 Aug 15. 347(7):472-80. [Medline].

  28. Dematteo RP, Ballman KV, Antonescu CR, Maki RG, Pisters PW, Demetri GD. Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial. Lancet. 2009 Mar 28. 373(9669):1097-104. [Medline].

  29. Joensuu H, Eriksson M, Sundby Hall K, Hartmann JT, Pink D, Schutte J. One vs three years of adjuvant imatinib for operable gastrointestinal stromal tumor: a randomized trial. JAMA. 2012 Mar 28. 307(12):1265-72. [Medline].

  30. Demetri GD, von Mehren M, Antonescu CR, et al. NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors. J Natl Compr Canc Netw. 2010 Apr. 8 Suppl 2:S1-41; quiz S42-4. [Medline].

  31. Demetri GD, van Oosterom AT, Garrett CR, et al. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: a randomised controlled trial. Lancet. 2006 Oct 14. 368(9544):1329-38. [Medline].

  32. George S, Blay JY, Casali PG, Le Cesne A, Stephenson P, Deprimo SE. Clinical evaluation of continuous daily dosing of sunitinib malate in patients with advanced gastrointestinal stromal tumour after imatinib failure. Eur J Cancer. 2009 Jul. 45(11):1959-68. [Medline].

  33. Demetri GD, Reichardt P, Kang YK, Blay JY, Rutkowski P, Gelderblom H, et al. Efficacy and safety of regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib (GRID): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013 Jan 26. 381(9863):295-302. [Medline].

  34. Chustecka Z. Regorafenib Approved for Gastrointestinal Stromal Tumors. Available at Accessed: March 5, 2013.

  35. Wu PC, Langerman A, Ryan CW, Hart J, Swiger S, Posner MC. Surgical treatment of gastrointestinal stromal tumors in the imatinib (STI-571) era. Surgery. 2003 Oct. 134(4):656-65; discussion 665-6. [Medline].

  36. Besana-Ciani I, Boni L, Dionigi G, Benevento A, Dionigi R. Outcome and long term results of surgical resection for gastrointestinal stromal tumors (GIST). Scand J Surg. 2003. 92(3):195-9. [Medline].

  37. Chen YH, Liu KH, Yeh CN, et al. Laparoscopic resection of gastrointestinal stromal tumors: safe, efficient, and comparable oncologic outcomes. J Laparoendosc Adv Surg Tech A. 2012 Oct. 22(8):758-63. [Medline].

  38. El-Gendi A, El-Gendi S, El-Gendi M. Feasibility and oncological outcomes of limited duodenal resection in patients with primary nonmetastatic duodenal GIST. J Gastrointest Surg. 2012 Dec. 16(12):2197-202. [Medline].

  39. Druker BJ, Tamura S, Buchdunger E, et al. Effects of a selective inhibitor of the Abl tyrosine kinase on the growth of Bcr-Abl positive cells. Nat Med. 1996 May. 2(5):561-6. [Medline].

  40. Druker BJ, Talpaz M, Resta DJ, et al. Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. N Engl J Med. 2001 Apr 5. 344(14):1031-7. [Medline].

  41. Buchdunger E, Zimmermann J, Mett H, et al. Inhibition of the Abl protein-tyrosine kinase in vitro and in vivo by a 2-phenylaminopyrimidine derivative. Cancer Res. 1996 Jan 1. 56(1):100-4. [Medline].

  42. Heinrich MC, Griffith DJ, Druker BJ, Wait CL, Ott KA, Zigler AJ. Inhibition of c-kit receptor tyrosine kinase activity by STI 571, a selective tyrosine kinase inhibitor. Blood. 2000 Aug 1. 96(3):925-32. [Medline].

  43. Tuveson DA, Willis NA, Jacks T, et al. STI571 inactivation of the gastrointestinal stromal tumor c-KIT oncoprotein: biological and clinical implications. Oncogene. 2001 Aug 16. 20(36):5054-8. [Medline].

  44. Blanke CD, von Mehren M, Joensuu H, et al. Presented at: American Society of Clinical Oncology 37th Annual Meeting. Evaluation of the safety and efficacy of an oral molecularly-targeted therapy, STI571, in patients with unresectable or metastatic gastrointestinal stromal tumors expressing C-KIT. San Francisco, Calif; 2001. Vol 20: abst 2.

  45. van Oosterom AT, Judson IR, Verweij J, et al. Update of phase I study of imatinib (STI571) in advanced soft tissue sarcomas and gastrointestinal stromal tumors: a report of the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer. 2002 Sep. 38 Suppl 5:S83-7. [Medline].

  46. Rink L, Skorobogatko Y, Kossenkov AV, et al. Gene expression signatures and response to imatinib mesylate in gastrointestinal stromal tumor. Mol Cancer Ther. 2009 Aug. 8(8):2172-82. [Medline]. [Full Text].

  47. Dematteo RP, Heinrich MC, El-Rifai WM, Demetri G. Clinical management of gastrointestinal stromal tumors: before and after STI-571. Hum Pathol. 2002 May. 33(5):466-77. [Medline].

  48. Crosby JA, Catton CN, Davis A, et al. Malignant gastrointestinal stromal tumors of the small intestine: a review of 50 cases from a prospective database. Ann Surg Oncol. 2001 Jan-Feb. 8(1):50-9. [Medline].

  49. Carney JA. Gastric stromal sarcoma, pulmonary chondroma, and extra-adrenal paraganglioma (Carney Triad): natural history, adrenocortical component, and possible familial occurrence. Mayo Clin Proc. 1999 Jun. 74(6):543-52. [Medline].

  50. Conlon KC, Casper ES, Brennan MF. Primary gastrointestinal sarcomas: analysis of prognostic variables. Ann Surg Oncol. 1995 Jan. 2(1):26-31. [Medline].

  51. Dougherty MJ, Compton C, Talbert M, Wood WC. Sarcomas of the gastrointestinal tract. Separation into favorable and unfavorable prognostic groups by mitotic count. Ann Surg. 1991 Nov. 214(5):569-74. [Medline].

  52. Adams VR, Leggas M. Sunitinib malate for the treatment of metastatic renal cell carcinoma and gastrointestinal stromal tumors. Clin Ther. 2007 Jul. 29(7):1338-53. [Medline].

  53. Agaram NP, Wong GC, Guo T, et al. Novel V600E BRAF mutations in imatinib-naive and imatinib-resistant gastrointestinal stromal tumors. Genes Chromosomes Cancer. 2008 Oct. 47(10):853-9. [Medline]. [Full Text].

  54. Al-Batran SE, Hartmann JT, Heidel F, et al. Focal progression in patients with gastrointestinal stromal tumors after initial response to imatinib mesylate: a three-center-based study of 38 patients. Gastric Cancer. 2007. 10(3):145-52. [Medline].

  55. Alam I, Kheradmand F, Alam S, Jamil A, Wilson I, Hurley M. Laparoscopic management of acutely presenting gastrointestinal stromal tumors: a study of 9 cases and review of literature. J Laparoendosc Adv Surg Tech A. 2007 Oct. 17(5):626-33. [Medline].

  56. An JY, Choi MG, Noh JH, et al. Gastric GIST: a single institutional retrospective experience with surgical treatment for primary disease. Eur J Surg Oncol. 2007 Oct. 33(8):1030-5. [Medline].

  57. Antman K, Crowley J, Balcerzak SP, et al. An intergroup phase III randomized study of doxorubicin and dacarbazine with or without ifosfamide and mesna in advanced soft tissue and bone sarcomas. J Clin Oncol. 1993 Jul. 11(7):1276-85. [Medline].

  58. Asakawa M, Sakamoto Y, Kajiwara T, et al. Simple segmental resection of the second portion of the duodenum for the treatment of gastrointestinal stromal tumors. Langenbecks Arch Surg. 2008 Jul. 393(4):605-9. [Medline].

  59. Badalamenti G, Rodolico V, Fulfaro F, et al. Gastrointestinal stromal tumors (GISTs): focus on histopathological diagnosis and biomolecular features. Ann Oncol. 2007 Jun. 18 Suppl 6:vi136-40. [Medline].

  60. Berthet B, Sugarbaker TA, Chang D, Sugarbaker PH. Quantitative methodologies for selection of patients with recurrent abdominopelvic sarcoma for treatment. Eur J Cancer. 1999 Mar. 35(3):413-9. [Medline].

  61. Blum MG, Bilimoria KY, Wayne JD, de Hoyos AL, Talamonti MS, Adley B. Surgical considerations for the management and resection of esophageal gastrointestinal stromal tumors. Ann Thorac Surg. 2007 Nov. 84(5):1717-23. [Medline].

  62. Brodsky SV, Gimenez C, Ghosh C, Melamed M, Ramaswamy G. Estrogen and progesterone receptors expression in gastrointestinal stromal tumors and intramural gastrointestinal leiomyomas. Int J Gastrointest Cancer. 2006. 37(4):129-32. [Medline].

  63. Bümming P, Nilsson O, Ahlman H, et al. Gastrointestinal stromal tumors regularly express synaptic vesicle proteins: evidence of a neuroendocrine phenotype. Endocr Relat Cancer. 2007 Sep. 14(3):853-63. [Medline].

  64. Catena F, Di Battista M, Fusaroli P, et al. Laparoscopic treatment of gastric GIST: report of 21 cases and literature's review. J Gastrointest Surg. 2008 Mar. 12(3):561-8. [Medline].

  65. Chustecka Z. Surgery Is Beneficial Even When GIST Responds to Imatinib. Medscape Medical News. January 23, 2013. Available at Accessed: February 5, 2013.

  66. Corless CL, Heinrich MC. Molecular pathobiology of gastrointestinal stromal sarcomas. Annu Rev Pathol. 2008. 3:557-86. [Medline].

  67. Desai J, Shankar S, Heinrich MC, et al. Clonal evolution of resistance to imatinib in patients with metastatic gastrointestinal stromal tumors. Clin Cancer Res. 2007 Sep 15. 13(18 Pt 1):5398-405. [Medline].

  68. Dong C, Jun-Hui C, Xiao-Jun Y, et al. Gastrointestinal stromal tumors of the rectum: Clinical, pathologic, immunohistochemical characteristics and prognostic analysis. Scand J Gastroenterol. 2007 Oct. 42(10):1221-9. [Medline].

  69. Eilber FC, Rosen G, Forscher C, Nelson SD, Dorey F, Eilber FR. Recurrent gastrointestinal stromal sarcomas. Surg Oncol. 2000 Aug. 9(2):71-5. [Medline].

  70. Elias A, Ryan L, Sulkes A, Collins J, Aisner J, Antman KH. Response to mesna, doxorubicin, ifosfamide, and dacarbazine in 108 patients with metastatic or unresectable sarcoma and no prior chemotherapy. J Clin Oncol. 1989 Sep. 7(9):1208-16. [Medline].

  71. Espinosa I, Lee CH, Kim MK, Rouse BT, Subramanian S, Montgomery K. A novel monoclonal antibody against DOG1 is a sensitive and specific marker for gastrointestinal stromal tumors. Am J Surg Pathol. 2008 Feb. 32(2):210-8. [Medline].

  72. Fernandez A, Sanguino A, Peng Z, et al. An anticancer C-Kit kinase inhibitor is reengineered to make it more active and less cardiotoxic. J Clin Invest. 2007 Dec. 117(12):4044-54. [Medline]. [Full Text].

  73. Fontana MG, Rossi E, Bassotti G, et al. Gastrointestinal stromal tumors: usefulness of immunohistochemistry, flow cytometry and fluorescence in situ hybridization. J Gastroenterol Hepatol. 2007 Nov. 22(11):1754-9. [Medline].

  74. Goettsch WG, Bos SD, Breekveldt-Postma N, Casparie M, Herings RM, Hogendoorn PC. Incidence of gastrointestinal stromal tumours is underestimated: results of a nation-wide study. Eur J Cancer. 2005 Dec. 41(18):2868-72. [Medline].

  75. Graham J, Debiec-Rychter M, Corless CL, Reid R, Davidson R, White JD. Imatinib in the management of multiple gastrointestinal stromal tumors associated with a germline KIT K642E mutation. Arch Pathol Lab Med. 2007 Sep. 131(9):1393-6. [Medline].

  76. Gutierrez JC, De Oliveira LO, Perez EA, Rocha-Lima C, Livingstone AS, Koniaris LG. Optimizing diagnosis, staging, and management of gastrointestinal stromal tumors. J Am Coll Surg. 2007 Sep. 205(3):479-91 (Quiz 524). [Medline].

  77. Hassan I, You YN, Shyyan R, et al. Surgically managed gastrointestinal stromal tumors: a comparative and prognostic analysis. Ann Surg Oncol. 2008 Jan. 15(1):52-9. [Medline].

  78. Holdsworth CH, Badawi RD, Manola JB, et al. CT and PET: early prognostic indicators of response to imatinib mesylate in patients with gastrointestinal stromal tumor. AJR Am J Roentgenol. 2007 Dec. 189(6):W324-30. [Medline].

  79. Issakov J, Jiveliouk I, Nachmany I, Klausner J, Merimsky O. A histopathological review of gastrointestinal related mesenchymal tumors: the hidden GIST. Isr Med Assoc J. 2007 Nov. 9(11):810-2. [Medline].

  80. Janeway KA, Liegl B, Harlow A, et al. Pediatric KIT wild-type and platelet-derived growth factor receptor alpha-wild-type gastrointestinal stromal tumors share KIT activation but not mechanisms of genetic progression with adult gastrointestinal stromal tumors. Cancer Res. 2007 Oct 1. 67(19):9084-8. [Medline].

  81. Jeon SW, Park YD, Chung YJ, et al. Gastrointestinal stromal tumors of the stomach: endosonographic differentiation in relation to histological risk. J Gastroenterol Hepatol. 2007 Dec. 22(12):2069-75. [Medline].

  82. Kee D, Zalcberg JR. Current and emerging strategies for the management of imatinib-refractory advanced gastrointestinal stromal tumors. Ther Adv Med Oncol. 2012 Sep. 4(5):255-70. [Medline]. [Full Text].

  83. Kim KM, Kang DW, Moon WS, Park JB, Park CK, Sohn JH. PKCtheta expression in gastrointestinal stromal tumor. Mod Pathol. 2006 Nov. 19(11):1480-6. [Medline].

  84. Kobayashi K, Szklaruk J, Trent JC, et al. Hepatic arterial embolization and chemoembolization for imatinib-resistant gastrointestinal stromal tumors. Am J Clin Oncol. 2009 Dec. 32(6):574-81. [Medline].

  85. McAuliffe JC, Lazar AJ, Yang D, et al. Association of intratumoral vascular endothelial growth factor expression and clinical outcome for patients with gastrointestinal stromal tumors treated with imatinib mesylate. Clin Cancer Res. 2007 Nov 15. 13(22 Pt 1):6727-34. [Medline].

  86. McWhinney SR, Pasini B, Stratakis CA. Familial gastrointestinal stromal tumors and germ-line mutations. N Engl J Med. 2007 Sep 6. 357(10):1054-6. [Medline].

  87. Meara RS, Cangiarella J, Simsir A, Horton D, Eltoum I, Chhieng DC. Prediction of aggressiveness of gastrointestinal stromal tumours based on immunostaining with bcl-2, Ki-67 and p53. Cytopathology. 2007 Oct. 18(5):283-9. [Medline].

  88. Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006 May. 23(2):70-83. [Medline].

  89. Miettinen M, Lasota J. Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med. 2006 Oct. 130(10):1466-78. [Medline].

  90. Nakajima K, Yasumasa K, Endo S, et al. A versatile dual-channel carbon dioxide (CO2) insufflator for various CO2)applications. The prototype. Surg Endosc. 2006 Feb. 20(2):334-8. [Medline].

  91. Nilsson B, Sjolund K, Kindblom LG, et al. Adjuvant imatinib treatment improves recurrence-free survival in patients with high-risk gastrointestinal stromal tumours (GIST). Br J Cancer. 2007 Jun 4. 96(11):1656-8. [Medline]. [Full Text].

  92. Nishimura J, Nakajima K, Omori T, et al. Surgical strategy for gastric gastrointestinal stromal tumors: laparoscopic vs. open resection. Surg Endosc. 2007 Jun. 21(6):875-8. [Medline].

  93. Rubio J, Marcos-Gragera R, Ortiz MR, et al. Population-based incidenceand survival of gastrointestinal stromal tumors (GIST) in Girona, Spain. Eur J Cancer. 2007. 43:144-148.

  94. Rutkowski P, Debiec-Rychter M, Nowecki ZI, et al. Different factors are responsible for predicting relapses after primary tumors resection and for imatinib treatment outcomes in gastrointestinal stromal tumors. Med Sci Monit. 2007 Nov. 13(11):CR515-522. [Medline].

  95. Sepe PS, Brugge WR. A guide for the diagnosis and management of gastrointestinal stromal cell tumors. Nat Rev Gastroenterol Hepatol. 2009 Jun. 6(6):363-71. [Medline].

  96. Sevinc A, Camci C, Yilmaz M, Buyukhatipoglu H. The diagnosis of C-kit negative GIST by PDGFRA staining: clinical, pathological, and nuclear medicine perspective. Onkologie. 2007 Dec. 30(12):645-8. [Medline].

  97. Steigen SE, Straume B, Turbin D, et al. Clinicopathologic factors and nuclear morphometry as independent prognosticators in KIT-positive gastrointestinal stromal tumors. J Histochem Cytochem. 2008 Feb. 56(2):139-45. [Medline]. [Full Text].

  98. Takahashi T, Nakajima K, Nishitani A, et al. An enhanced risk-group stratification system for more practical prognostication of clinically malignant gastrointestinal stromal tumors. Int J Clin Oncol. 2007 Oct. 12(5):369-74. [Medline].

  99. Trent JC, Lazar AJ, Zhang W. Molecular approaches to resolve diagnostic dilemmas: the case of gastrointestinal stromal tumor and leiomyosarcoma. Future Oncol. 2007 Dec. 3(6):629-37. [Medline].

  100. Tryggvason G, Gislason HG, Magnusson MK, Jonasson JG. Gastrointestinal stromal tumors in Iceland, 1990-2003: the icelandic GIST study, a population-based incidence and pathologic risk stratification study. Int J Cancer. 2005 Nov 1. 117(2):289-93. [Medline].

  101. Tsukuda K, Hirai R, Miyake T, et al. The outcome of gastrointestinal stromal tumors (GISTs) after a surgical resection in our institute. Surg Today. 2007. 37(11):953-7. [Medline].

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