Gastrointestinal Stromal Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Resistant / Refractory Gastrointestinal Stromal Tumors
Eventual development of resistance to both imatinib and sunitinib is nearly universal. There is no standard therapy when this occurs, and patients should be considered for investigational therapy. Additional oral TKIs are under investigation. For example, in a preliminary case series, nilotinib has shown biological activity, with unknown impact on survival.
The initial approach to the patient is to evaluate the following parameters:
Detection of a monoclonal (or myeloma) protein (M protein) in the serum or urine.
Detection of more than 10% of plasma cells on a bone marrow examination.
Detection of lytic bone lesions or generalized osteoporosis in skeletal x-rays.
Presence of soft tissue plasmacytomas.
Serum albumin and beta-2-microglobulin levels.
Detection of free kappa and lambda serum immunoglobulin light...
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with gastrointestinal stromal tumor. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
Montemurro M, Schöffski P, Reichardt P, et al.: Nilotinib in the treatment of advanced gastrointestinal stromal tumours resistant to both imatinib and sunitinib. Eur J Cancer 45 (13): 2293-7, 2009.