Clinical management of gastrointestinal stromal tumors: Before and after STI-571 Journal Article


Authors: DeMatteo, R. P.; Heinrich, M. C.; El-Rifai, W. M.; Demetri, G.
Article Title: Clinical management of gastrointestinal stromal tumors: Before and after STI-571
Abstract: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Until recently, surgery has been the only effective therapy for GIST. However, even after complete resection of tumor, many patients still eventually die of disease recurrence. Conventional chemotherapy and radiation therapy have been of limited value. Within the last few years, it was discovered that most GISTs have a gain-of-function mutation in the c-kit proto-oncogene. This results in ligand-independent activation of the KIT receptor tyrosine kinase and an unopposed stimulus for cell growth. STI-571 is a small molecule that selectively inhibits the enzymatic activity of the ABL, platelet-derived growth factor receptor, and KIT tyrosine kinases and the BCR-ABL fusion protein and is a landmark development in cancer therapy. Its clinical development marks a new era of rational and targeted molecular inhibition of cancer that emanates from direct collaborations between scientists and clinicians. It provides proof of the principle that a specific molecular inhibitor can drastically and selectively alter the survival of a neoplastic cell with a particular genetic aberration. The advent of STI-571 has markedly altered the clinical approach to GIST. It has proven to be effective in metastatic GIST and is also under investigation as a neoadjuvant and adjuvant therapy. Copyright 2002, Elsevier Science (USA). All rights reserved.
Keywords: adult; aged; aged, 80 and over; middle aged; survival analysis; cancer surgery; survival rate; unclassified drug; gene mutation; mutation; cisplatin; doxorubicin; cancer combination chemotherapy; antineoplastic agents; conference paper; gemcitabine; paclitaxel; cancer radiotherapy; chemotherapy, adjuvant; chemotherapy; antineoplastic agent; gastrointestinal stromal tumor; imatinib; proto-oncogene proteins c-kit; dacarbazine; metastasis; radiation; etoposide; granulocyte macrophage colony stimulating factor; tumor markers, biological; platelet derived growth factor receptor; protein tyrosine kinase; pyrimidines; ifosfamide; docetaxel; sarcoma; gastrointestinal neoplasms; stroma; surgery; epirubicin; mitomycin c; bcr abl protein; piperazines; stromal cells; therapy; oncogene c kit; gastrointestinal tumor; sti-571; mesenchymoma; humans; human; male; female; ct 2584; c-kit proto-oncogene
Journal Title: Human Pathology
Volume: 33
Issue: 5
ISSN: 0046-8177
Publisher: Elsevier Inc.  
Date Published: 2002-05-01
Start Page: 466
End Page: 477
Language: English
DOI: 10.1053/hupa.2002.124122
PUBMED: 12094371
PROVIDER: scopus
DOI/URL:
Notes: Based on presentations given at the National Institutes of Health Workshop on Gastrointestinal Stromal Tumors; 2001 Apr 2-3; Bethesda, MD -- Export Date: 14 November 2014 -- Source: Scopus
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  1. Ronald P DeMatteo
    637 DeMatteo