晚期或转移性胃肠道间质瘤治疗进展

Progress in the treatment of advanced and metastatic gastrointestinal stromal tumor

胃肠道间质瘤(gastrointestinal stromal tumor,GIST)是胃肠道最常见的间叶组织来源肿瘤,由于基因突变类型多样,GIST的临床病程特点和预后具有较大的异质性。虽然以伊马替尼为代表的一系列酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)给GIST患者带来了前所未有的生存获益,但多数患者仍会出现疾病进展或者转移的临床结局。对于晚期或转移性GIST,药物的选择以及手术在治疗中的适应证是近年来的研究热点。随着对GIST发病和耐药机制的研究深入,新型靶向药瑞派替尼、阿伐替尼以及作用于其他多通路靶点药物的出现使晚期/或转移性GIST的治疗模式更加精准化。本文就晚期或转移性GIST治疗现状及最新进展进行综述。

Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal tumors of the gastrointestinal tract.Extensive heterogeneity exists in the clinical course and prognosis of GISTs due to multiple genetic mutations.Since the advent of tyrosine kinase inhibitors(TKIs),such as imatinib,the survival of patients with GISTs has substsntially improved.However,progression or metastasis often occurs in these patients.For advanced and metastatic GISTs,drug selection and surgical indications have been studied and debated in recent years.With further research in etiology and TKI resistance,novel target agents such as ripretinib,avapritinib,and other pathway inhibitors have been introduced into clinical practice,enabling a more individualized and accurate treatment modality for advanced and metastatic GISTs.This review provides an update on the current therapeutic development landscape in advanced and metastatic GISTs.