Metastatic GISTs: Identification, prognosis, and acquiring support
In the journey of dealing with metastatic Gastrointestinal Stromal Tumor (GIST), emotional, psychological, and practical support can make a significant difference. Healthcare professionals, support groups, friends, and family can provide valuable assistance, offering comfort and guidance during a challenging time.
While standard chemotherapy and surgery may not be effective for GISTs, there is hope. Newer targeted biologic therapies are proving to be effective for advanced GISTs. One such treatment is Regorafenib (Stivarga), which affects KIT, PDGFRA, and other proteins, preventing tumor growth by preventing the creation of new blood vessels.
The fight against metastatic GIST is far from over, with clinical trials being conducted to explore novel treatment options. Current clinical trials for metastatic GIST include a range of targeted therapies and mutation-specific approaches. For instance, a Phase 1/2 master protocol study is evaluating DCC-3009 for safety, tolerability, and efficacy in GIST treatment, particularly for the SDH-mutant/deficient GIST subtype, which is currently resistant to FDA-approved therapies like imatinib and sunitinib.
Extending and optimizing imatinib therapy duration is another focus of ongoing Phase 3 trials, such as INSIGHT and Peak, which are investigating mutation-specific treatment guided by circulating tumor DNA in advanced GIST. Novel agents like NB003 and IDRX-42 are advancing in clinical development, targeting resistant mutations, alongside established drugs like ripretinib and avapritinib.
Ponatinib is another treatment option for metastatic GIST, particularly for those who have failed prior treatments, focusing on targeting resistant mutations. A Phase II trial is currently enrolling patients for this treatment.
In addition to these targeted therapies, the combination of axitinib (a tyrosine kinase inhibitor) and pembrolizumab (an immunotherapy agent) is being assessed in advanced/metastatic soft tissue sarcomas, including GIST components, showing meaningful clinical activity.
Imatinib mesylate (Gleevec) remains the preferred treatment for metastatic GIST, as it is a selective inhibitor of the KIT and PDGFRA genes. Sunitinib (Sutent) may be recommended if the cancer does not respond to imatinib or if imatinib causes severe side effects.
Avapritinib (Ayvakyt) is a newly approved treatment for metastatic GIST that cannot be removed with surgery, specifically for tumors with a specific exon 18 mutation in the PDGFRA gene.
Participation in a clinical trial can provide access to experimental treatments not otherwise available. Joining support groups, either in person or online, can offer a sense of community and understanding, a platform to share experiences, learn from others, and gain practical insights into coping with the challenges posed by metastatic GIST.
It's important to note that a complete cure for metastatic GIST is not guaranteed, but medical advancements have substantially improved disease management. The 5-year relative survival rate for localized GIST is 95%, while for GIST that has metastasized locally, it is 84%. If it has metastasized to distal areas, the survival rate is 52%.
In summary, ongoing clinical trials for metastatic GIST focus on mutation-specific targeted therapies, extending and optimizing imatinib therapy duration, combining TKIs with immunotherapy, and exploring treatments for subtypes resistant to standard TKIs. These trials represent the leading edge of research to improve outcomes for metastatic GIST patients beyond currently approved therapies.
Remember, it's crucial to have open conversations with your healthcare team about any concerns and receive guidance on treatment options, symptom management, and addressing issues.
- In the journey of fighting metastatic Gastrointestinal Stromal Tumor (GIST), researchers are exploring new treatment options through clinical trials, such as DCC-3009 for SDH-mutant/deficient GIST subtype.
- The gist of current clinical trials for metastatic GIST involves mutation-specific targeted therapies, extending and optimizing imatinib therapy duration, and combining targeted therapies with immunotherapy.
- When it comes to health-and-wellness, it's essential for patients dealing with metastatic GIST to be aware of the ongoing research on therapies-and-treatments, like avapritinib for specific exon 18 mutations, and to participate in clinical trials to access experimental treatments.
