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gross

Gastrointestinal stromal tumor (GIST)

A very rare, but life-threatening tumor

Gastrointestinal stromal tumors, or GISTs for short, are relatively rare malignant connective tissue tumors (sarcomas) in the gastrointestinal tract. GIST only accounts for 1-3% of all gastrointestinal tumors, about ten to twenty cases per million people per year. GISTs are mostly diagnosed between 55 and 60 years of age, while other, more common tumors in the intestines are often detected in people over 60.

Often detected too late and only found by chance

Patients usually do not experience specific signs or symptoms. As the tumor grows outward, not inward, there is usually no obstruction of the gut. Very often GIST tumors are found by chance during a diagnostic procedure done for a different reason. This means that diagnosis is often made relatively late when the tumor has already spread.

In retrospect, many patients say that they have been experiencing a vague discomfort or stomach pain in the past. The first therapeutic measure in GISTs is surgical removal of the tumor if it hasn’t spread yet – however because of the late diagnosis this is not successful in many cases. Once they have spread, GISTs are life-threatening tumors.

GIST: Paradigm of personalized medicine

In the last decade, GIST has become the paradigm of individual therapy. Scientists discovered that most GIST tumors are characterized by very typical changes (mutations) of the tumor cells in one of two genes. The mutation causes the internal signals in the cells to go out of control, and it distinguishes GIST cells from all other cells in the body.

This has enabled science to develop a targeted approach to therapy, by concentrating on cells with this mutation. All normal body cells without the mutation remain unaffected by the therapeutic approach. There are two current standard medications for medical GIST treatment if the tumor cannot be surgically removed and/or have already spread. Eventually, however, these drugs lose their efficacy because new mutations occur or alternative signaling pathways develop in the tumor cells.

New drug for GIST under investigation

Bayer HealthCare has conducted an international clinical trial with a new drug in GIST patients whose tumor had progressed after treatment with both standard medications. The results are positive.

Advice for patients
Every body reacts differently to medicines. Therefore it is impossible to tell which medicine works best for you. Please consult your physician.