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May 2017

Defining the Impact of Adjuvant Therapy in Molecularly Defined Subsets of Gastrointestinal Stromal Tumor : From Lumping to Splitting

Author Affiliations
  • 1Portland Veterans Affairs Health Care System, Portland, Oregon
  • 2Knight Cancer Institute, Oregon Health and Science University, Portland
  • 3Dana-Farber Cancer Institute and Ludwig Center at Harvard Medical School, Boston, Massachusetts
JAMA Oncol. 2017;3(5):597-599. doi:10.1001/jamaoncol.2016.5740

In 1998, the modern era of recognizing gastrointestinal stromal tumor (GIST) as a unique entity began, with a report linking KIT protein expression and gene mutations to the putative cell of origin for GIST.1 Immunohistochemical detection of the KIT protein provided a tool to distinguish GIST from other types of cancer (particularly leiomyosarcoma). With accurate diagnosis, it became clear that while some cases of metastatic leiomyosarcoma responded to chemotherapy, the response rate of GIST was essentially 0%.2 Therefore, KIT expression could be used to identify patients with GIST who would not benefit from conventional chemotherapy.