Table 2.
Anatomic distribution, frequency and treatment response of the most common GISTs groups.
Genetic Type | Frequency | Anatomic Location | Treatment | |
---|---|---|---|---|
KIT mutations | ||||
Exon 8 | <0.1% | |||
Exon 9 | 6% | small & large bowel | Imatinib sensitiv (800 mg/d) | |
Exon 11 | 66% | all locations | Imatinib sensitive | |
Exon 13 | 1% | all locations | usually secondary mutation resistant to imatinib, responds to sunitinib | |
Exon 17 | <1% | all locations | secondary mutation resistant to imatinib and sunitinib; have been shown to respond to other TKI like regorafenib | |
PDGFRA mutations | ||||
Exon 12 | 1% | all locations | ||
Exon 14 | <1% | stomach | Imatinib sensitiv | |
Exon 18 D842V | 6% | stomach | Imatinib/sunitinib resistant; good respons to avapritinib | |
Exon 18 others | 1% | all locations | response to imatinib reported | |
KIT/PDGFRA “wild-type” | Limited responses to imatinib Possible response to other TKIs (limited data) |
|||
SDHB IHC+/SDH-competent | NF1 mutation (assoc. with RD) | <1% | small bowel | |
NRAS/HRAS/KRAS mutations | <1% | all locations (limited data) | ||
BRAF mutation | 1% | most commonly stomach | ||
Other rare mutations/fusions | all locations (limited data) |
|||
SDHB IHC−/SDH-deficient | SDHA/B/C/D mutations (CSS) | 2% | stomach | |
Part of the CT * | 1% | stomach | ||
SDHA mutation (young adults) | stomach | |||
Sporadic pediatric wt- GIST | 1% | stomach |
Legend: CSS: Carney–Stratakis Syndrome; CT: Carney triad; *: most cases show promotor hypermethylation.