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Liquid Biopsy in Gastrointestinal Stromal Tumors: Ready for Prime Time?

  • Sarcoma (SH Okuno, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Gastrointestinal stromal tumor (GIST) constitutes a paradigm for clinically effective targeted inhibition of oncogenic driver mutations. Therefore, GIST has emerged as a compelling clinical and biological model to study oncogene addiction and to validate preclinical concepts for drug response and drug resistance. Oncogenic activation of KIT or PDGFRA receptor tyrosine kinases is the essential drivers of GIST progression throughout all stages of the disease. Interestingly, KIT/PDGFRA genotype predicts the response to first-line imatinib and to all tyrosine kinase inhibitors (TKIs) approved or in investigation after imatinib failure. Considering that TKIs are effective only against a subset of KIT or PDGFRA resistance mutations, close monitoring of tumor dynamics with non-invasive methods such as liquid biopsy emerges as a necessary step forward in the field. Liquid biopsy, in contrast to solid tumor biopsy, aims to characterize tumors irrespective of heterogeneity. Although there are several components in the peripheral blood, most recent studies have been focused on circulating tumor (ct)DNA, due to the technological feasibility, the stability of DNA itself and DNA alterations, and the therapeutic development in precision oncology largely based on the identification of genetic driver mutations. In the present review, we systematically dissect the current wealth of data of ctDNA in GIST. To do so, a critical understanding of the promises and limitations of the current technologies will be followed by an exposition of the knowledge gathered with such studies in GIST. Collectively, our goal is to establish clear premises that can be used as the foundations to build future studies towards the clinical implementation of ctDNA evaluation in GIST patients.

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Funding

C.S. has received research funding from Karyopharm, Pfizer, Inc, Deciphera Pharmaceuticals, and Bayer AG; consulting fees (advisory role) from Immunicum AB, Deciphera Pharmaceuticals and Blueprint Medicines; payment for lectures from Bayer AG and Blueprint Medicines; and travel grants from Pharmamar, Pfizer, Bayer AG, Novartis and Lilly. D.P.J has received travel grants from Pfizer, Roemmers and Roche. The remaining authors declare no conflicts of interests

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  1. Sarcoma Translational Research Laboratory, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Hospital Campus, C/ Natzaret 115-117, 08035, Barcelona, Spain

    David Gómez-Peregrina MSc, Alfonso García-Valverde MSc, Daniel Pilco-Janeta MD & César Serrano MD, PhD

  2. Department of Medical Oncology, Vall d’Hebron University Hospital, P/Vall d’Hebron 119, 08035, Barcelona, Spain

    César Serrano MD, PhD

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  1. David Gómez-Peregrina MSc
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David Gómez-Peregrina declares that he has no conflict of interest. Alfonso García-Valverde declares that he has no conflict of interest. Daniel Pilco-Janeta has received travel grants from Pfizer, Roemmers, and Roche. César Serrano has received research funding (paid to his institution) from Karyopharm Therapeutics, Pfizer, Deciphera Pharmaceuticals, and Bayer AG; has received consulting fees (advisory role) from Immunicum AB, Deciphera Pharmaceuticals, and Blueprint Medicines; has received payment for lectures from Bayer AG and Blueprint Medicines; and has received travel grants from PharmaMar, Pfizer, Bayer AG, Novartis, and Lilly

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Gómez-Peregrina, D., García-Valverde, A., Pilco-Janeta, D. et al. Liquid Biopsy in Gastrointestinal Stromal Tumors: Ready for Prime Time?. Curr. Treat. Options in Oncol. 22, 32 (2021). https://doi.org/10.1007/s11864-021-00832-5

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