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Imatinib and gastrointestinal stromal tumors: Where do we go from here?

¹ Department of Oncology, Istituto Toscano Tumori, San Giuseppe Hospital, Empoli (Florence), Italy and ² Department of Medical Oncology, Erasmus University Medical Center, Daniel den Hoed, Rotterdam, the Netherlands

Requests for reprints: Ugo De Giorgi, Department of Oncology, Istituto Toscano Tumori, San Giuseppe Hospital, Via Paladini 40, 50053 Empoli (Florence), Italy. Phone: 349-2221235. E-mail: ugo_degiorgi{at}yahoo.com

Imatinib has tremendously changed the treatment of gastrointestinal stromal tumor (GIST). Research is currently focusing on its optimal use and the mechanisms of resistance that may emerge. A multidisciplinary approach including medical oncologists, surgeons, radiologists, and pathologists is crucial for the optimal management of these patients. Moreover, imatinib treatment in GIST represents an extraordinary model to expand our knowledge on the molecular mechanisms that are basic to the effects of molecularly targeted therapies. This review summarizes the existing knowledge of the imatinib treatment in GIST and describes directions for further development.

Key Words: Imatinib • KIT • Gastrointestinal stromal tumor • Imaging • Mechanisms of resistance

Received 11/10/04; revised 12/22/04; accepted 12/28/04.