Gastrointestinal stromal tumour: the decisions you may face

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

1. 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.
2. 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.
3. 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.
4. Does your recommendation follow the current guideline (NCCN Guidelines: GIST), and if it departs from it, why?
   Why: Departures from guidelines are sometimes right for an individual; they should be explained.
5. For my situation (localised, resectable), which of the standard options do you recommend and why?
   Why: Guideline options include: Complete resection without lymphadenectomy; adjuvant imatinib 3 years for high-risk (SSGXVIII); neoadjuvant imatinib to downsize when organ-sparing matters.
6. 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.

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

1. Between Imatinib and Avapritinib, 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.
2. 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.
3. 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.
4. Does your recommendation follow the current guideline (NCCN Guidelines: GIST), and if it departs from it, why?
   Why: Departures from guidelines are sometimes right for an individual; they should be explained.
5. For my situation (advanced, first line), which of the standard options do you recommend and why?
   Why: Guideline options include: Imatinib 400 mg (800 mg for KIT exon 9); avapritinib for PDGFRA D842V; continue until progression.
6. Am I a candidate for Imatinib, Avapritinib, 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.

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

1. Between Sunitinib, Ripretinib and Liquid biopsy (ctDNA), 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.
2. 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.
3. 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.
4. Does your recommendation follow the current guideline (NCCN Guidelines: GIST), and if it departs from it, why?
   Why: Departures from guidelines are sometimes right for an individual; they should be explained.
5. For my situation (advanced, second line), which of the standard options do you recommend and why?
   Why: Guideline options include: Sunitinib (or ripretinib for KIT exon 11 + 17/18 secondary mutations per ctDNA, INSIGHT).
6. Am I a candidate for Sunitinib, Ripretinib, 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.

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

1. Between Regorafenib and Ripretinib, 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.
2. 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.
3. 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.
4. Does your recommendation follow the current guideline (NCCN Guidelines: GIST), and if it departs from it, why?
   Why: Departures from guidelines are sometimes right for an individual; they should be explained.
5. For my situation (advanced, third/fourth line), which of the standard options do you recommend and why?
   Why: Guideline options include: Regorafenib, then ripretinib (INVICTUS); rechallenge or continue TKI beyond progression; clinical trials (bezuclastinib-sunitinib).
6. Am I a candidate for Regorafenib, Ripretinib, 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.