The whole "case" is to go, the rejuvenation of the | peak circuit, multiple surgeries and polygenic mutation GIST patients meet new hope

Gastrointestinal stromal tumors (GIST) are the most common mesophyllous tumors of the digestive tract, and their pathogenesis is mainly acquired mutations

Case introduction

medical history

• Abdominal CT: mid-abdominal and lower abdominal mass lesions (8.
  
  Small intestinal GIST; High risk; c-KIT Exon11 mutation

  Treatment progression

  • Adjuvant therapy
    
    The patient was diagnosed with small intestinal GIST in 2009, with a high risk, KIT exon 11 mutation
    
    

    Zheng Chuang Physician

    • Department of Gastrointestinal Surgery, Union Hospital Affiliated to Fujian Medical University

    • Professional Doctor of Union Medical College Affiliated to Fujian Medical University

    Professor Lin Tao

    • Deputy Chief Physician, Master of Medicine

    • Member of the Rapid Rehabilitation Group of the Stomach Cancer Professional Committee of Fujian Anti-Cancer Association

    • He is a member of the Stomach Cancer Professional Committee of Fujian Maritime Medical Association

    • Member of Fuzhou Medical Malpractice Appraisal Committee

    Case reviews

    Professor Zhou Yongjian

    Union Hospital Affiliated to Fujian Medical University

    
    

    The patient in this case was diagnosed with small intestine GIST in 2009, and has been in the course of about 13 years so far, and the treatment process can be described as a twist and turn

    
    
    
    

    In fact, for patients with recurrent metastatic GIST who have undergone multiple surgeries and multiple genetic mutations coexist, it is not easy

    
    

    Review experts

    Professor Zhou Yongjian

    • Department of Gastrointestinal Surgery, Union Hospital Affiliated to Fujian Medical University

    • Chief physician, doctoral supervisor

    • Doctor of Medicine, Peking University

    • Member of the GIST Professional Committee of the Chinese Medical Doctor Association

    • Member of the CSCO GIST Professional Committee

    
    
    
    

    Question 1: Correct answer: D

    
    

    Analysis: In 2021, the NAVIGATOR study published in the journal Eur J Cancer showed that among GIST patients with the PDGFRA D842V mutation treated with avatinib, the mPFS reached 34.

    
    
    
    

    Question 2: Correct answer: D

    
    

    Analysis: On March 31, 2021, the State Food and Drug Administration (NMPA) approved avatinib for the treatment of adult patients with PDGFRA exon 18 (including D842V) mutation unresectable or metastatic GIST, and alvatinib is also the only type I TKI

    
    
    Edit: Max Typography: Koen
    Execution: Yogi