Beecroft J Robert, Brar Savtaj, Feng Xiaolan, Hamilton Trevor, Han-Lee Cheng, Henning Jan-Willem, Josephy P David, Khalili Korosh, Ko Yoo-Joung, Lemieux Christopher, Liu David M, MacDonald D Blair, Noujaim Jonathan, Pollett Aaron, Salawu Abdulazeez, Saleh Ramy, Smrke Alannah, Warren Blair E, Zbuk Kevin, Razak Albiruni Abdul
Division of Interventional Radiology, Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, Toronto, ON, Canada.
Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
Ther Adv Med Oncol. 2024 Aug 2;16:17588359241266179. doi: 10.1177/17588359241266179. eCollection 2024.
Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours that originate from the interstitial cells of Cajal. GISTs are mainly driven by gain-of-function mutations in receptor tyrosine kinase or platelet-derived growth factor receptor alpha. Surgical resection is the only curative treatment for localized tumours and all currently approved medical GIST treatments are based on orally available tyrosine kinase inhibitors. Recent discoveries in the molecular and clinical features of GISTs have greatly impacted GIST management. Due to the provincially rather than nationally administered Canadian healthcare system, there have been inconsistencies in the treatment of GISTs across the country. Therefore, guidance on the latest knowledge, clinical management and treatment of GIST is needed to standardize the approach to GIST management nationwide. To establish pan-Canadian guidance, provide up-to-date data and harmonize the clinical practice of GIST management in high- and low-throughput centres across Canada; a panel of 20 physicians with extensive clinical experience in GIST management reviewed relevant literature. This included radiologists, pathologists, interventional radiologists, surgeons and medical oncologists across Canada. The structured literature focused on seven key domains: molecular profiling, radiological techniques/reporting, targeted localized therapy, intricacies of systemic treatments, emerging tests, multidisciplinary care and patient advocacy. This literature review, along with clinical expertise and opinion, was used to develop this concise and clinically relevant consensus paper to harmonize the knowledge and clinical practice on GIST management across Canada. The content presented here will help guide healthcare providers, especially in Canada, in terms of approaching and managing GIST.
胃肠道间质瘤(GISTs)是起源于 Cajal 间质细胞的间叶组织肿瘤。GISTs 主要由受体酪氨酸激酶或血小板衍生生长因子受体α的功能获得性突变驱动。手术切除是局限性肿瘤的唯一治愈性治疗方法,目前所有获批的 GIST 医学治疗均基于口服酪氨酸激酶抑制剂。GISTs 在分子和临床特征方面的最新发现对 GIST 的管理产生了重大影响。由于加拿大医疗保健系统是由各省而非全国管理,全国各地在 GIST 的治疗上存在不一致性。因此,需要有关 GIST 最新知识、临床管理和治疗的指南,以规范全国范围内 GIST 的管理方法。为了制定全加拿大的指南,提供最新数据并协调加拿大高通量和低通量中心 GIST 管理的临床实践;一个由 20 名在 GIST 管理方面具有丰富临床经验的医生组成的小组对相关文献进行了审查。其中包括加拿大各地的放射科医生、病理科医生、介入放射科医生、外科医生和医学肿瘤学家。结构化文献聚焦于七个关键领域:分子谱分析、放射学技术/报告、靶向局部治疗、全身治疗的复杂性、新兴检测、多学科护理和患者宣传。这篇文献综述,连同临床专业知识和意见,被用于撰写这份简洁且与临床相关的共识文件,以统一加拿大各地关于 GIST 管理的知识和临床实践。此处呈现的内容将有助于指导医疗服务提供者,尤其是加拿大的医疗服务提供者,处理和管理 GIST。