Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of ESMO

Jean Yves Blay, Sylvie Bonvalot, Paolo Casali, Haesun Choi, Maria Debiec-Richter, A. P. Dei Tos, Jean Francois Emile, Alessandro Gronchi, Pancras C W Hogendoorn, Heikki Joensuu, Axel Le Cesne, Joan Mac Clure, Joan Maurel, Ninna Nupponen, Isabelle Ray-Coquard, Peter Reichardt, Raf Sciot, Sigrid Stroobants, Martine van Glabbeke, Allan van OosteromGeorge D. Demetri, Ianis Boukovinas, Pierre Meeus, Jim Janinis, Rosella Bertulli, Maurizio Colecchia, Antonella Messina, Elena Tamborini, Seiichi Hirota, Toshirou Nishida, Javier Martin, Andres Poveda, Rafael Ramos, Louis Guillou, Serge Leyvraz, Mike Leahy, Christopher Corless, Ronald DeMatteo, John Zalcberg, Dolores Knufer, Aage Schultz, Ian Judson, Beatrice Fervers, Binh Bui, Frits Van Coevorden, Robert Benjamin, Robert Maki, Jaap Verweij, Ole Nielsen, Michael Heinrich, Bert Van Geel, Larry Baker, Margaret von Mehren, Thor Alvegard, Jean Michel Coindre, Karen Antman, Peter Hohenberger, Kirsten Sundby-Hall, Piotr Rutkowski

Research output: Contribution to journalArticle

497 Citations (Scopus)

Abstract

Background: The management of gastrointestinal stromal tumors (GIST) has evolved very rapidly in the last 4 years. The objectives of this international consensus meeting were to describe the optimal management procedures for patients with GIST in localized and advanced stages, as well as research issues for the future. Materials and methods: A panel of experts from six specialties, including pathology, molecular biology, imaging, surgery, medical oncology and methodologists for clinical practice guidelines from different European and extra European sarcoma societies were invited to a 2-day workshop. Several questions were selected by the organizing committee prior to the conference. Selected panelists reviewed the current levels of evidence for each point, and presented their conclusions during the meeting. These proposals were discussed, and consensus points were identified and categorized according to the Standard Options Recommandations (SOR) of the French Federation of Cancer Centers and National Comprehensive Cancer Network (NCCN). Results: Thirty-two consensus points were identified, most from categories 2A of the NCCN and B2 of the SOR. Among these, the standard histological examination with immunohistochemical analysis using CD117, CD34, PS100, desmin and smooth muscle actin is considered standard. Molecular biology for the identification of KIT and PDGFRA mutation is an optional diagnostic procedure for GIST with negative CD117 staining, and otherwise is considered a research procedure. Complete tumor resection with negative tumor margins is the standard surgical treatment. Adjuvant imatinib after optimal tumor resection as well as neo-adjuvant imatinib remain experimental approaches to be performed within prospective clinical studies. Imatinib should be started at the date of diagnosis of metastatic relapse and given until development of intolerance or progressive disease. The optimal criteria for tumor response to imatinib remain to be delineated, and should include not only tumor size reduction or disease stabilization, but also reduction of tumor density (Hounsfield Units) on computed tomography and metabolic activity (i.e. reduction of FDG uptake on positron emission tomography). In a substantial proportion of patients, stable disease and even increase in tumor size may be associated with pathologic response to imatinib therapy, and available survival data indicate that the survival of these patients is similar to that of patients with conventional tumor response. Metastasis resection is an experimental procedure. Conclusions: Consensus points in clinical management of GIST as well as questions for future clinical trials were identified during this consensus conference on GIST management.

Original languageEnglish (US)
Pages (from-to)566-578
Number of pages13
JournalAnnals of Oncology
Volume16
Issue number4
DOIs
StatePublished - Apr 2005
Externally publishedYes

Fingerprint

Gastrointestinal Stromal Tumors
Neoplasms
Molecular Biology
Negative Staining
Molecular Imaging
Desmin
Survival
Medical Oncology
Practice Guidelines
Research
Sarcoma
Positron-Emission Tomography
Smooth Muscle
Actins
Tomography
Imatinib Mesylate
Clinical Trials
Prospective Studies
Pathology
Neoplasm Metastasis

Keywords

  • Consensus
  • ESMO
  • GIST
  • Imatinib

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of ESMO. / Blay, Jean Yves; Bonvalot, Sylvie; Casali, Paolo; Choi, Haesun; Debiec-Richter, Maria; Dei Tos, A. P.; Emile, Jean Francois; Gronchi, Alessandro; Hogendoorn, Pancras C W; Joensuu, Heikki; Le Cesne, Axel; Mac Clure, Joan; Maurel, Joan; Nupponen, Ninna; Ray-Coquard, Isabelle; Reichardt, Peter; Sciot, Raf; Stroobants, Sigrid; van Glabbeke, Martine; van Oosterom, Allan; Demetri, George D.; Boukovinas, Ianis; Meeus, Pierre; Janinis, Jim; Bertulli, Rosella; Colecchia, Maurizio; Messina, Antonella; Tamborini, Elena; Hirota, Seiichi; Nishida, Toshirou; Martin, Javier; Poveda, Andres; Ramos, Rafael; Guillou, Louis; Leyvraz, Serge; Leahy, Mike; Corless, Christopher; DeMatteo, Ronald; Zalcberg, John; Knufer, Dolores; Schultz, Aage; Judson, Ian; Fervers, Beatrice; Bui, Binh; Van Coevorden, Frits; Benjamin, Robert; Maki, Robert; Verweij, Jaap; Nielsen, Ole; Heinrich, Michael; Van Geel, Bert; Baker, Larry; von Mehren, Margaret; Alvegard, Thor; Coindre, Jean Michel; Antman, Karen; Hohenberger, Peter; Sundby-Hall, Kirsten; Rutkowski, Piotr.

In: Annals of Oncology, Vol. 16, No. 4, 04.2005, p. 566-578.

Research output: Contribution to journalArticle

Blay, JY, Bonvalot, S, Casali, P, Choi, H, Debiec-Richter, M, Dei Tos, AP, Emile, JF, Gronchi, A, Hogendoorn, PCW, Joensuu, H, Le Cesne, A, Mac Clure, J, Maurel, J, Nupponen, N, Ray-Coquard, I, Reichardt, P, Sciot, R, Stroobants, S, van Glabbeke, M, van Oosterom, A, Demetri, GD, Boukovinas, I, Meeus, P, Janinis, J, Bertulli, R, Colecchia, M, Messina, A, Tamborini, E, Hirota, S, Nishida, T, Martin, J, Poveda, A, Ramos, R, Guillou, L, Leyvraz, S, Leahy, M, Corless, C, DeMatteo, R, Zalcberg, J, Knufer, D, Schultz, A, Judson, I, Fervers, B, Bui, B, Van Coevorden, F, Benjamin, R, Maki, R, Verweij, J, Nielsen, O, Heinrich, M, Van Geel, B, Baker, L, von Mehren, M, Alvegard, T, Coindre, JM, Antman, K, Hohenberger, P, Sundby-Hall, K & Rutkowski, P 2005, 'Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of ESMO', Annals of Oncology, vol. 16, no. 4, pp. 566-578. https://doi.org/10.1093/annonc/mdi127
Blay, Jean Yves ; Bonvalot, Sylvie ; Casali, Paolo ; Choi, Haesun ; Debiec-Richter, Maria ; Dei Tos, A. P. ; Emile, Jean Francois ; Gronchi, Alessandro ; Hogendoorn, Pancras C W ; Joensuu, Heikki ; Le Cesne, Axel ; Mac Clure, Joan ; Maurel, Joan ; Nupponen, Ninna ; Ray-Coquard, Isabelle ; Reichardt, Peter ; Sciot, Raf ; Stroobants, Sigrid ; van Glabbeke, Martine ; van Oosterom, Allan ; Demetri, George D. ; Boukovinas, Ianis ; Meeus, Pierre ; Janinis, Jim ; Bertulli, Rosella ; Colecchia, Maurizio ; Messina, Antonella ; Tamborini, Elena ; Hirota, Seiichi ; Nishida, Toshirou ; Martin, Javier ; Poveda, Andres ; Ramos, Rafael ; Guillou, Louis ; Leyvraz, Serge ; Leahy, Mike ; Corless, Christopher ; DeMatteo, Ronald ; Zalcberg, John ; Knufer, Dolores ; Schultz, Aage ; Judson, Ian ; Fervers, Beatrice ; Bui, Binh ; Van Coevorden, Frits ; Benjamin, Robert ; Maki, Robert ; Verweij, Jaap ; Nielsen, Ole ; Heinrich, Michael ; Van Geel, Bert ; Baker, Larry ; von Mehren, Margaret ; Alvegard, Thor ; Coindre, Jean Michel ; Antman, Karen ; Hohenberger, Peter ; Sundby-Hall, Kirsten ; Rutkowski, Piotr. / Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of ESMO. In: Annals of Oncology. 2005 ; Vol. 16, No. 4. pp. 566-578.
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title = "Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of ESMO",
abstract = "Background: The management of gastrointestinal stromal tumors (GIST) has evolved very rapidly in the last 4 years. The objectives of this international consensus meeting were to describe the optimal management procedures for patients with GIST in localized and advanced stages, as well as research issues for the future. Materials and methods: A panel of experts from six specialties, including pathology, molecular biology, imaging, surgery, medical oncology and methodologists for clinical practice guidelines from different European and extra European sarcoma societies were invited to a 2-day workshop. Several questions were selected by the organizing committee prior to the conference. Selected panelists reviewed the current levels of evidence for each point, and presented their conclusions during the meeting. These proposals were discussed, and consensus points were identified and categorized according to the Standard Options Recommandations (SOR) of the French Federation of Cancer Centers and National Comprehensive Cancer Network (NCCN). Results: Thirty-two consensus points were identified, most from categories 2A of the NCCN and B2 of the SOR. Among these, the standard histological examination with immunohistochemical analysis using CD117, CD34, PS100, desmin and smooth muscle actin is considered standard. Molecular biology for the identification of KIT and PDGFRA mutation is an optional diagnostic procedure for GIST with negative CD117 staining, and otherwise is considered a research procedure. Complete tumor resection with negative tumor margins is the standard surgical treatment. Adjuvant imatinib after optimal tumor resection as well as neo-adjuvant imatinib remain experimental approaches to be performed within prospective clinical studies. Imatinib should be started at the date of diagnosis of metastatic relapse and given until development of intolerance or progressive disease. The optimal criteria for tumor response to imatinib remain to be delineated, and should include not only tumor size reduction or disease stabilization, but also reduction of tumor density (Hounsfield Units) on computed tomography and metabolic activity (i.e. reduction of FDG uptake on positron emission tomography). In a substantial proportion of patients, stable disease and even increase in tumor size may be associated with pathologic response to imatinib therapy, and available survival data indicate that the survival of these patients is similar to that of patients with conventional tumor response. Metastasis resection is an experimental procedure. Conclusions: Consensus points in clinical management of GIST as well as questions for future clinical trials were identified during this consensus conference on GIST management.",
keywords = "Consensus, ESMO, GIST, Imatinib",
author = "Blay, {Jean Yves} and Sylvie Bonvalot and Paolo Casali and Haesun Choi and Maria Debiec-Richter and {Dei Tos}, {A. P.} and Emile, {Jean Francois} and Alessandro Gronchi and Hogendoorn, {Pancras C W} and Heikki Joensuu and {Le Cesne}, Axel and {Mac Clure}, Joan and Joan Maurel and Ninna Nupponen and Isabelle Ray-Coquard and Peter Reichardt and Raf Sciot and Sigrid Stroobants and {van Glabbeke}, Martine and {van Oosterom}, Allan and Demetri, {George D.} and Ianis Boukovinas and Pierre Meeus and Jim Janinis and Rosella Bertulli and Maurizio Colecchia and Antonella Messina and Elena Tamborini and Seiichi Hirota and Toshirou Nishida and Javier Martin and Andres Poveda and Rafael Ramos and Louis Guillou and Serge Leyvraz and Mike Leahy and Christopher Corless and Ronald DeMatteo and John Zalcberg and Dolores Knufer and Aage Schultz and Ian Judson and Beatrice Fervers and Binh Bui and {Van Coevorden}, Frits and Robert Benjamin and Robert Maki and Jaap Verweij and Ole Nielsen and Michael Heinrich and {Van Geel}, Bert and Larry Baker and {von Mehren}, Margaret and Thor Alvegard and Coindre, {Jean Michel} and Karen Antman and Peter Hohenberger and Kirsten Sundby-Hall and Piotr Rutkowski",
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month = "4",
doi = "10.1093/annonc/mdi127",
language = "English (US)",
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pages = "566--578",
journal = "Annals of Oncology",
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TY - JOUR

T1 - Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of ESMO

AU - Blay, Jean Yves

AU - Bonvalot, Sylvie

AU - Casali, Paolo

AU - Choi, Haesun

AU - Debiec-Richter, Maria

AU - Dei Tos, A. P.

AU - Emile, Jean Francois

AU - Gronchi, Alessandro

AU - Hogendoorn, Pancras C W

AU - Joensuu, Heikki

AU - Le Cesne, Axel

AU - Mac Clure, Joan

AU - Maurel, Joan

AU - Nupponen, Ninna

AU - Ray-Coquard, Isabelle

AU - Reichardt, Peter

AU - Sciot, Raf

AU - Stroobants, Sigrid

AU - van Glabbeke, Martine

AU - van Oosterom, Allan

AU - Demetri, George D.

AU - Boukovinas, Ianis

AU - Meeus, Pierre

AU - Janinis, Jim

AU - Bertulli, Rosella

AU - Colecchia, Maurizio

AU - Messina, Antonella

AU - Tamborini, Elena

AU - Hirota, Seiichi

AU - Nishida, Toshirou

AU - Martin, Javier

AU - Poveda, Andres

AU - Ramos, Rafael

AU - Guillou, Louis

AU - Leyvraz, Serge

AU - Leahy, Mike

AU - Corless, Christopher

AU - DeMatteo, Ronald

AU - Zalcberg, John

AU - Knufer, Dolores

AU - Schultz, Aage

AU - Judson, Ian

AU - Fervers, Beatrice

AU - Bui, Binh

AU - Van Coevorden, Frits

AU - Benjamin, Robert

AU - Maki, Robert

AU - Verweij, Jaap

AU - Nielsen, Ole

AU - Heinrich, Michael

AU - Van Geel, Bert

AU - Baker, Larry

AU - von Mehren, Margaret

AU - Alvegard, Thor

AU - Coindre, Jean Michel

AU - Antman, Karen

AU - Hohenberger, Peter

AU - Sundby-Hall, Kirsten

AU - Rutkowski, Piotr

PY - 2005/4

Y1 - 2005/4

N2 - Background: The management of gastrointestinal stromal tumors (GIST) has evolved very rapidly in the last 4 years. The objectives of this international consensus meeting were to describe the optimal management procedures for patients with GIST in localized and advanced stages, as well as research issues for the future. Materials and methods: A panel of experts from six specialties, including pathology, molecular biology, imaging, surgery, medical oncology and methodologists for clinical practice guidelines from different European and extra European sarcoma societies were invited to a 2-day workshop. Several questions were selected by the organizing committee prior to the conference. Selected panelists reviewed the current levels of evidence for each point, and presented their conclusions during the meeting. These proposals were discussed, and consensus points were identified and categorized according to the Standard Options Recommandations (SOR) of the French Federation of Cancer Centers and National Comprehensive Cancer Network (NCCN). Results: Thirty-two consensus points were identified, most from categories 2A of the NCCN and B2 of the SOR. Among these, the standard histological examination with immunohistochemical analysis using CD117, CD34, PS100, desmin and smooth muscle actin is considered standard. Molecular biology for the identification of KIT and PDGFRA mutation is an optional diagnostic procedure for GIST with negative CD117 staining, and otherwise is considered a research procedure. Complete tumor resection with negative tumor margins is the standard surgical treatment. Adjuvant imatinib after optimal tumor resection as well as neo-adjuvant imatinib remain experimental approaches to be performed within prospective clinical studies. Imatinib should be started at the date of diagnosis of metastatic relapse and given until development of intolerance or progressive disease. The optimal criteria for tumor response to imatinib remain to be delineated, and should include not only tumor size reduction or disease stabilization, but also reduction of tumor density (Hounsfield Units) on computed tomography and metabolic activity (i.e. reduction of FDG uptake on positron emission tomography). In a substantial proportion of patients, stable disease and even increase in tumor size may be associated with pathologic response to imatinib therapy, and available survival data indicate that the survival of these patients is similar to that of patients with conventional tumor response. Metastasis resection is an experimental procedure. Conclusions: Consensus points in clinical management of GIST as well as questions for future clinical trials were identified during this consensus conference on GIST management.

AB - Background: The management of gastrointestinal stromal tumors (GIST) has evolved very rapidly in the last 4 years. The objectives of this international consensus meeting were to describe the optimal management procedures for patients with GIST in localized and advanced stages, as well as research issues for the future. Materials and methods: A panel of experts from six specialties, including pathology, molecular biology, imaging, surgery, medical oncology and methodologists for clinical practice guidelines from different European and extra European sarcoma societies were invited to a 2-day workshop. Several questions were selected by the organizing committee prior to the conference. Selected panelists reviewed the current levels of evidence for each point, and presented their conclusions during the meeting. These proposals were discussed, and consensus points were identified and categorized according to the Standard Options Recommandations (SOR) of the French Federation of Cancer Centers and National Comprehensive Cancer Network (NCCN). Results: Thirty-two consensus points were identified, most from categories 2A of the NCCN and B2 of the SOR. Among these, the standard histological examination with immunohistochemical analysis using CD117, CD34, PS100, desmin and smooth muscle actin is considered standard. Molecular biology for the identification of KIT and PDGFRA mutation is an optional diagnostic procedure for GIST with negative CD117 staining, and otherwise is considered a research procedure. Complete tumor resection with negative tumor margins is the standard surgical treatment. Adjuvant imatinib after optimal tumor resection as well as neo-adjuvant imatinib remain experimental approaches to be performed within prospective clinical studies. Imatinib should be started at the date of diagnosis of metastatic relapse and given until development of intolerance or progressive disease. The optimal criteria for tumor response to imatinib remain to be delineated, and should include not only tumor size reduction or disease stabilization, but also reduction of tumor density (Hounsfield Units) on computed tomography and metabolic activity (i.e. reduction of FDG uptake on positron emission tomography). In a substantial proportion of patients, stable disease and even increase in tumor size may be associated with pathologic response to imatinib therapy, and available survival data indicate that the survival of these patients is similar to that of patients with conventional tumor response. Metastasis resection is an experimental procedure. Conclusions: Consensus points in clinical management of GIST as well as questions for future clinical trials were identified during this consensus conference on GIST management.

KW - Consensus

KW - ESMO

KW - GIST

KW - Imatinib

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