GIST is a rare cancer of the digestive system

About 3,000 to 6,000 people in the United States are diagnosed with gastrointestinal stromal tumor (GIST) each year. SUTENT is approved to treat the portion of patients whose GIST did not stop growing when taking the medicine Gleevec or who cannot take Gleevec.

How GIST starts and spreads

Cancer cells are abnormal versions of healthy cells. So, they grow in a way similar to healthy cells. Here is how these cells grow and spread:

  • A single GIST cell grows and divides to form 2 cells. These 2 cells divide to form 4 cells. This process repeats, again and again
  • Unlike healthy cells, cancer cells do not respond to your body’s cues telling them to stop growing
  • A tumor can be detected once enough cancer cells are made
  • Some cancer cells may enter the bloodstream, spreading from the stroma to other parts of the body
  • New tumors may arise in other organs. If this happens, the cancer is known as metastatic. But, no matter where the cancer spreads, it will still be called GIST, because it started in the stroma

GIST starts in a part of the body called the stroma. The stroma is the lining of the digestive tract. Doctors believe that it may be caused by a gene mutation. In other words, GIST is not likely caused by a person’s diet or lifestyle choices.

Stages of GIST

There are 4 stages of GIST. To determine the cancer's stage, doctors use 4 pieces of information:

  • Where the tumor started
  • The size of the tumor
  • If and where the tumor has spread
  • The mitotic rate (how fast the cancer cells are growing and dividing)

For GIST that starts in the stomach or omentum (a layer of fatty tissue over the organs in the abdomen):

Stage
Definition
Stage IA
  • The tumor is 5 centimeters or less in size
  • It has not spread
  • The mitotic rate is low
Stage IB
  • The tumor is between 5 and 10 centimeters in size
  • It has not spread
  • The mitotic rate is low
Stage II
  • The tumor is 5 centimeters or less in size
  • It has not spread
  • The mitotic rate is high

OR

  • The tumor is larger than 10 centimeters in size
  • It has not spread
  • The mitotic rate is low
Stage IIIA
  • The tumor is between 5 and 10 centimeters in size
  • It has not spread
  • The mitotic rate is high
Stage IIIB
  • The tumor is larger than 10 centimeters in size
  • It has not spread
  • The mitotic rate is high
Stage IV
  • The tumor is any size
  • It has spread to nearby lymph nodes and/or distant sites, such as the liver
  • The mitotic rate can be high or low
Image is not actual size

The image below is an example of tumor size.

Golf ball (5 cm)

For GIST that starts in the small intestine, esophagus, colon, rectum, or peritoneum (layer of tissue lining the organs and walls of the abdomen):

Stage
Definition
Stage I
  • The tumor is 5 centimeters or less in size
  • It has not spread
  • The mitotic rate is low
Stage II
  • The tumor is between 5 and 10 centimeters in size
  • It has not spread
  • The mitotic rate is low
Stage IIIA
  • The tumor is 2 centimeters or less in size
  • It has not spread
  • The mitotic rate is high

OR

  • The tumor is larger than 10 centimeters in size
  • It has not spread
  • The mitotic rate is low
Stage IIIB
  • The tumor is larger than 2 centimeters in size
  • It has not spread
  • The mitotic rate is high
Stage IV
  • The tumor is any size
  • It has spread to nearby lymph nodes and/or distant sites, such as the liver
  • The mitotic rate can be high or low

Some potential treatments to consider

Depending on the stage of the cancer, several treatments may be available.

These can include:

Surgery
Smaller tumors can be removed through surgery. Larger tumors are usually treated with medicine before surgery is attempted.

Watchful waiting
This involves monitoring a patient’s condition carefully without giving any treatment until signs or symptoms appear or change.

Supportive care
Aims to prevent, or treat, the symptoms of a disease, side effects caused by treatment, or other psychological, social, and spiritual problems related to a disease or its treatment.

Radiation therapy
Uses high-energy radiation to kill cancer cells or keep them from growing. Radiation is typically used to ease the pain and symptoms of GIST.

Chemotherapy
Uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. There are some chemotherapy medicines available to patients with GIST, but not many, and these are not a standard treatment for this type of cancer. Because other cells in the body also divide very quickly (bone marrow cells and hair follicles, for example), these cells are also often affected by chemotherapy. This can lead to certain side effects. Therefore, it is rarely used to treat GIST. More often, a therapy that acts on specific or unique features of cancer cells is more often used in combination with surgery.

Other drugs that inhibit a specific or unique feature of cancer cells
Drug therapy that treats GIST in a few different ways. SUTENT is one of those therapies; it blocks an enzyme and keeps tumors from making their own blood vessels, which are needed to deliver oxygen and other nutrients to help them survive and grow. In so doing, SUTENT can slow cancer growth and may prevent the spread of cancer cells. SUTENT is not a cure, and not all patients will experience the same results.

SUTENT results

SUTENT has been proven effective in the treatment of GIST in certain patients

A clinical trial proved that SUTENT is an effective treatment for certain patients with GIST.

4 times the number of months without tumor growth

Patients treated with SUTENT lived 4 times the number of months without tumor growth compared to patients given a placebo.

The data represent a median. SUTENT is not a cure and not all patients will experience the same results.

SUTENT is used to treat GIST (gastrointestinal stromal tumor). This is a rare cancer of the stomach, bowel, or esophagus. SUTENT is used when the medicine Gleevec® (imatinib mesylate) did not stop the cancer from growing, or when you cannot take Gleevec. Gleevec is a registered trademark of Novartis AG.