Neoadjuvant Treatment Strategies in Gastrointestinal Stromal Tumors

Gastrointestinal stromal tumors (GISTs) are rare neoplasms originating in the mesenchyme of the gastrointestinal tract. An evolving treatment paradigm in the management of GISTs is the usage of neoadjuvant therapy (NAT). Prior to undergoing NAT, GISTs must be genetically tested. The main benefit of NAT is reduction of operative morbidity. Response to NAT is generally assessed by contrast-enhanced computed tomography or MRI at regular intervals. Patients are treated to maximal response, which is often 8 to 12 months. After resection, selected patients should continue systemic treatment, for a total of 3 years of therapy before entering posttreatment surveillance.