Gastrointestinal stromal tumor

Rare mesenchymal GI tumor arising from interstitial cells of Cajal. 80% of patients carry an activating mutation in KIT or PDGFRA, which determines sensitivity to tyrosine kinase inhibitors. Per ESMO 2022 and SEOM 2023, first-line for metastatic or unresectable disease – imatinib; on progression – sunitinib (2nd line), regorafenib (3rd), ripretinib (4th). Resectable disease is treated surgically, with possible 3-year adjuvant imatinib.

ICD-10 C26.91 drug

Also known as: GIST

Drugs used for this condition

ASunitinibSecond line · Multi-target tyrosine kinase inhibitor – VEGFR, PDGFR, c-KIT, FLT3, RETGastrointestinal stromal tumor (GIST) in adults after progression on imatinib or imatinib intolerance. Per ESMO 2022 and SEOM 2023 – second-line. Dose: 50 mg orally once daily on the 4/2 schedule or 37.5 mg continuous daily dosing. Efficacy depends on KIT/PDGFRA mutation subtype.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit