Therapy for Advanced Gastrointestinal Stromal Tumors

The emergence of molecularly targeted drugs, initially represented by imatinib, changed the traditional treatment regimen of GIST and formed a concept of surgery combined with molecular-targeted drugs. Although most GISTs are sensitive to imatinib at the beginning of treatment, more than 50% will eventually develop imatinib resistance. Thus, managing advanced GIST has become a key issue. Patients with advanced GIST who do not respond to standard-dose imatinib treatment can proceed with individualized therapies of high-dose imatinib, second-line or third-line medications, TKI combined with radiofrequency ablation (RFA), or first-line plus second-line combination medication. Systemic therapy is often needed for patients with advanced GIST and combined surgical intervention can reduce tumor burden and prolong survival. However, determining how to apply these treatments rationally is a clinical problem that needs to be solved urgently. Therefore, it is necessary to make full use of the multidisciplinary treatment model to weigh the risks and benefits and obtain the best clinical effect.