KIT exon 11-mutant GIST: the decisions you may face
4 treatment settings, 3 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.
Localised, resectable
Complete surgical resection without lymphadenectomy; laparoscopic for smaller gastric tumours; neoadjuvant imatinib for large or poorly placed tumours.
The drug that started the targeted therapy era in 2001, turning chronic myeloid leukaemia into a manageable condition with near-normal life expectancy.
Surgeons operate through small incisions using robotic arms with tremor-free precision and 3D vision.
- Precision, shorter stay
- Enables complex minimally invasive resections
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
- Take with a meal and a large glass of water.
- Cost
- Loss of haptic feedback
- Not superior for every indication
- Between Imatinib and Robotic & minimally invasive surgery, which do you recommend for me, and what about my case would make you choose differently?Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
- What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?Why: The aim shapes how much side effect and disruption is worth accepting.
- What happens if I delay, or decline this step for now? Is the decision reversible?Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
- For my situation (localised, resectable), which of the standard options do you recommend and why?Why: Guideline options include: Complete surgical resection without lymphadenectomy; laparoscopic for smaller gastric tumours; neoadjuvant imatinib for large or poorly placed tumours.
- Am I a candidate for Imatinib, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
Add these to your appointment list, or take the full question set for this cancer.
After resection, high risk
Three years of adjuvant imatinib 400 mg (SSG XVIII); trials of longer courses.
The drug that started the targeted therapy era in 2001, turning chronic myeloid leukaemia into a manageable condition with near-normal life expectancy.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
- Take with a meal and a large glass of water.
- Is Imatinib the only reasonable path for me, or is there a trial, a different sequence or a wait-and-see option?Why: A single standard does not mean a single choice; timing and trials are decisions too.
- What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?Why: The aim shapes how much side effect and disruption is worth accepting.
- What happens if I delay, or decline this step for now? Is the decision reversible?Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
- For my situation (after resection, high risk), which of the standard options do you recommend and why?Why: Guideline options include: Three years of adjuvant imatinib 400 mg (SSG XVIII); trials of longer courses.
- Am I a candidate for Imatinib, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
Add these to your appointment list, or take the full question set for this cancer.
Metastatic, first line
Imatinib 400 mg continued until progression, with CT response assessment by Choi criteria.
The drug that started the targeted therapy era in 2001, turning chronic myeloid leukaemia into a manageable condition with near-normal life expectancy.
A CT scan is a fast 3D X-ray that shows the size and shape of tumours and whether they have spread.
- Fast, ubiquitous
- Sub-millimetre resolution
- Standard for RECIST response
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
- Take with a meal and a large glass of water.
- Anatomic only; cannot distinguish scar from live tumour
- Radiation dose
- Poor for brain, marrow, and small peritoneal disease
- Between Imatinib and CT (computed tomography), which do you recommend for me, and what about my case would make you choose differently?Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
- What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?Why: The aim shapes how much side effect and disruption is worth accepting.
- What happens if I delay, or decline this step for now? Is the decision reversible?Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
- For my situation (metastatic, first line), which of the standard options do you recommend and why?Why: Guideline options include: Imatinib 400 mg continued until progression, with CT response assessment by Choi criteria.
- Am I a candidate for Imatinib, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
Add these to your appointment list, or take the full question set for this cancer.
Progression on imatinib
Dose escalation to 800 mg, then sunitinib, regorafenib and ripretinib, ideally guided by the secondary mutation on circulating tumour DNA.
The drug that started the targeted therapy era in 2001, turning chronic myeloid leukaemia into a manageable condition with near-normal life expectancy.
Sunitinib is an anti-angiogenic pill approved for pancreatic neuroendocrine tumours, kidney cancer and GIST.
A sorafenib successor that became the first second-line drug proven to prolong life in liver cancer (2017).
A fourth-line GIST drug that locks KIT in an off state regardless of which resistance mutation the tumour has acquired.
A blood test that reads fragments of DNA shed by the tumour, so you can genotype or monitor cancer without a needle in the tumour.
- Minimally invasive, repeatable
- Whole-body clonal picture
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
- Take with a meal and a large glass of water.
- Avoid grapefruit.
- Known QT prolongation. Avoid other QT-prolonging drugs where possible; check ECG and correct potassium and magnesium before and during treatment.
- Take with a low-fat breakfast (under 30% fat).
- Not recommended in severe impairment; hepatotoxicity is a boxed warning.
- Low shedding in some tumours (brain, early-stage)
- Clonal haematopoiesis false positives
- Between Imatinib, Sunitinib, Regorafenib and the other options, which do you recommend for me, and what about my case would make you choose differently?Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
- What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?Why: The aim shapes how much side effect and disruption is worth accepting.
- What happens if I delay, or decline this step for now? Is the decision reversible?Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
- For my situation (progression on imatinib), which of the standard options do you recommend and why?Why: Guideline options include: Dose escalation to 800 mg, then sunitinib, regorafenib and ripretinib, ideally guided by the secondary mutation on circulating tumour DNA.
- Am I a candidate for Imatinib, Sunitinib, Regorafenib or related drugs, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
Add these to your appointment list, or take the full question set for this cancer.