Letters To The Editor
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 28, 2013; 19(16): 2583-2586
Published online Apr 28, 2013. doi: 10.3748/wjg.v19.i16.2583
Role of molecular analysis in the adjuvant treatment of gastrointestinal stromal tumours: It is time to define it
Margherita Nannini, Maria A Pantaleo, Guido Biasco
Margherita Nannini, Maria A Pantaleo, Guido Biasco, Department of Hematology and Oncological Sciences “LA Seràgnoli”, Sant’Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
Maria A Pantaleo, Guido Biasco, “Giorgio Prodi” Cancer Research Center, University of Bologna, 40138 Bologna, Italy
Author contributions: All the authors contributed to this letter.
Correspondence to: Dr. Margherita Nannini, Department of Hematology and Oncological Sciences “LA Seragnoli" , Sant’Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. maggie.nannini@gmail.com
Telephone: +39-51-6364078 Fax: +39-51-6364037
Received: February 6, 2013
Revised: March 25, 2013
Accepted: April 3, 2013
Published online: April 28, 2013
Processing time: 84 Days and 12.2 Hours
Abstract

Sendur et al pointed out the attention on the importance of mutational analysis for adjuvant treatment of gastrointestinal stromal tumor (GIST) in an article published in World Journal of Gastroenterology. In particular, they suggested that the optimal dose and duration of adjuvant therapy could be defined by the mutational status of the primary disease. This comment would underline the importance of centralised laboratories, given the increasingly important role of molecular analysis in the work-flow of all GIST, and the need of retrospective analyses for subgroups population stratified for the mutational status from the available studies in the adjuvant setting, in order to define the role of mutational analysis in choosing the optimal dose and duration of adjuvant therapy.

Keywords: Gastrointestinal stromal tumours; Platelet-derived growth factor receptor alpha; KIT; Wild-type; Molecular analysis; Imatinib; Adjuvant treatment

Core tip: Sendur et al pointed out the attention on the importance of mutational analysis for adjuvant treatment of gastrointestinal stromal tumor (GIST). In particular, they suggested that the optimal dose and duration of adjuvant therapy could be defined by the mutational status of the primary disease. This topic represents a big challenge in GIST’s management by now, because even if the molecular analysis is strictly recommended in the work-flow of all GIST, its role in the adjuvant setting remains still unsettled due to the lack of prospective large clinical trials. In particular we pointed out the attention on the KIT/platelet-derived growth factor receptor alpha wild type GIST, that are extremely heterogeneous both in clinical and molecular background, making difficult their management also in the adjuvant setting. Our comment would underline the importance of centralised laboratories, given the increasingly important role of molecular analysis in the work-flow of all GIST, and the need of retrospective analyses for subgroups population stratified for the mutational status from the available studies in the adjuvant setting, in order to define the role of mutational analysis in choosing the optimal dose and duration of adjuvant therapy.