Treatment of Benign Esophageal Tumor in Esophageal GIST with Primary Non-Resectability
This protocol covers esophageal gastrointestinal stromal tumor (GIST) classified as a benign esophageal tumor, specifically in cases where primary surgical resection is not immediately achievable.
Clinical Scenario
Esophageal gastrointestinal stromal tumor (GIST) with primary non-resectability. According to current ESMO guidelines, neoadjuvant treatment for downstaging is indicated in this setting, with evaluation of tumor regression at 3–4 monthly intervals.
Treatment Goal
Maximal radiological tumor regression, assessed at 3–4 monthly intervals, as a prerequisite for subsequent surgical consideration.
Approach — partial overview
Systemic neoadjuvant therapy with a tyrosine kinase inhibitor — such as imatinib — is used to achieve tumor downstaging in this setting; specific agent selection depends on molecular findings detailed in the full protocol.
References
DOI: 10.1515/iss-2023-0011
According to the latest ESMO guidelines, neoadjuvant treatment for downstaging is indicated in case of primary non-resectability, with evaluation of tumor regression in 3–4 monthly intervals.
Imatinib or other tyrosine kinase-inhibitors such as sunitinib, regorafenib (in case of wildtype KIT/PDGFR-A) or avapritinib (in case of wildtype PDGFRA-D842V mutation) can be used as systemic neoadjuvant or adjuvant treatment.
Surgical resection is then scheduled once maximal radiological tumor regression is achieved.
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