Gastrointestinal Stromal Tumor Adjuvant Therapy After Surgery

After undergoing surgery for gastrointestinal stromal tumor (GIST), patients often require adjuvant therapy to reduce the risk of recurrence. The type and duration of postoperative treatment largely depend on the tumor's recurrence risk classification, which is determined through pathological and genetic analysis. Patients categorized as high-risk, intermediate-risk, or low-risk are generally advised to undergo adjuvant therapy following surgery.

One of the key steps in determining the appropriate treatment plan is conducting genetic testing, including the detection of CD117 and other relevant gene mutations. If no specific mutations are identified, the standard first-line treatment is imatinib (Gleevec), which has shown significant efficacy in preventing recurrence. The duration of imatinib therapy varies depending on the patient's risk level—typically, higher-risk patients require longer treatment periods, often continuing until disease progression or recurrence.

In cases where the cancer recurs and imatinib is no longer effective, second-line therapy with sunitinib (Sutent) is usually initiated. Sunitinib can effectively control the disease in many patients, especially those who respond well to targeted therapy. If the tumor progresses while on sunitinib, adjustments in dosage or a switch to alternative therapies may be considered based on the patient's condition and response to treatment.

Regular follow-up and monitoring are essential throughout the course of adjuvant therapy. Imaging studies and biomarker assessments help doctors evaluate treatment effectiveness and make timely interventions when necessary. Adjuvant therapy plays a crucial role in improving long-term outcomes for GIST patients after surgery.