Definition of AdjuvantA recent study in JAMA Oncology found that patients who undergo primary GIST resection might not receive the optimal recommended duration of adjuvant therapy, which can impact their recurrence-free survival (RFS).

The study was conducted by medical record review reported by oncologists who participated. Patients who had primary GIST resection after 2010 were evaluated based on whether or not their oncologist’s charted risk assessments were lower than assessments based on the Revised National Institutes of Health Consensus Criteria. According to the findings, physicians tend to underestimate risk of recurrence.

Although the study evaluated data from only 109 oncologists and 506 patients, the important take away from this is that there are still GIST patients with tumors of intermediate size, intermediate-level mitotic rates or non-gastric locations who are not receiving the recommendation of at least three years or more of adjuvant treatment following resection. Patients who receive three years or more of planned adjuvant treatment are shown to have longer RFS.

Importance of  Seeing a GIST Specialist

The study affirms the importance of being treated by a GIST specialist and/or being treated at a medical center that has sarcoma specialists. It is clear that more education is necessary for oncologists and surgeons who treat GIST patients, and vital that patients become informed and advocate for themselves when weighing treatment options. The LRG maintains a GIST Specialist database which can be accessed here.

The FDA issued recommendations on adjuvant treatment in 2012.

Evaluating risk of recurrence

More information on risk of recurrence can be found on the LRG website. Every case is individual, and should always be discussed directly with your treatment team.

Mary Garland
Author: Mary Garland