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The Use of Molecular Subtypes for Precision Therapy of Recurrent and Metastatic Gastrointestinal Stromal Tumor

Authors Liu P, Tan F, Liu H, Li B, Lei T, Zhao X

Received 6 December 2019

Accepted for publication 10 March 2020

Published 24 March 2020 Volume 2020:13 Pages 2433—2447

DOI https://doi.org/10.2147/OTT.S241331

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Takuya Aoki


Peng Liu,1,* Fengbo Tan,1,* Heli Liu,1 Bin Li,2 Tianxiang Lei,1 Xianhui Zhao1

1Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, People’s Republic of China; 2Department of Oncology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Heli Liu
Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha 410008, Hunan, People’s Republic of China
Tel +86 13874967285
Email heliliu@csu.edu.cn

Abstract: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor in the digestive tract. Tyrosine kinase inhibitors (TKIs), represented by imatinib, sunitinib, and regorafenib, have become the main treatment for recurrent and metastatic GISTs. With the wide application of mutation analysis and the precision medicine, molecular characteristics have been determined that not only predict the prognosis of patients with recurrent and metastatic GISTs, but also are closely related to the efficacy of first-, second- and third-line TKIs for GISTs, as well as other TKIs. Despite the significant effects of TKIs, the emergence of primary and secondary resistance ultimately leads to treatment failure and tumor progression. Currently, due to the signal transmission of KIT/PDGFRA during onset and tumor progression, strategies to counteract drug resistance include the replacement of TKIs and the development of new drugs that are directed towards carcinogenic mutations. In addition, it is also the embodiment of precision medicine for GISTs to explore new carcinogenic mechanisms and develop new drugs relying on new biotechnology. Surgery can benefit specific patients but its major purpose is to diminish the resistant clones. However, the prognosis of recurrent and metastatic patients is still unsatisfactory. Therefore, it is worth paying attention to how to maximize the benefits for patients.

Keywords: gastrointestinal stromal tumor, tyrosine kinase inhibitor, precise medicine

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