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Because imatinib (Gleevec) and sunitinib (Sutent) do not kill all GIST cancer cells, new treatment ideas under development include:
- combination trials of imatinib or sunitinib plus other drugs
- imatinib plus surgery in specified sequences
- heat shock protein inhibitors
- other tyrosine kinase inhibitors including sorafenib, nilotinib, dasatinib, etc.
- inhibitors of downstream pathways such as PI3K, mTOR, MAPK
- cell cycle inhibitors
- proteasome inhibitors
A number of consensus documents summarizing expert opinion about GIST treatment are available, including those listed below.
NCCN Task Force Report: Optimal Management of Patients with GIST -- 2010 Update. This is a long (40-page pdf) and detailed guidelines booklet written by a panel of experts. It contains plenty of useful information to guide oncologists in treatment of GIST.
NCCN Task Force Report: Optimal Management of Patients with GIST -- 2007 Update of the NCCN Clinical Practice Guidelines. This earlier NCCN guide includes some information such as drug interactions and side effects of special concern to patients that is not found in the 2010 update.
NCCN Soft Tissue Sarcoma Guidelines This document, updated at least annually, includes flow charts for GIST diagnosis and treatment.
European Society for Medical Oncology GIST guidelines "Gastrointestinal stromal tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up" by P.G. Casali and J.-Y. Blay on behalf of the ESMO/CONTICANET/EUUROBONET Consensus Panel of Experts
Annals of Oncology 21 (supplement 5): v98-v102, 2010.
French National Federation of Cancer Centers consensus guidelines written in French (Recommandations pour la prise en charge des tumeurs stromales gastro-intestinales (GIST)
Canadian Advisory Committee on GIST statement Gastrointestinal stromal tumours: Consensus statement on diagnosis and treatment (Blackstein et al, 2006).
