Clinical Trials Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2017; 23(32): 5925-5935
Published online Aug 28, 2017. doi: 10.3748/wjg.v23.i32.5925
Characterizing gastrointestinal stromal tumors and evaluating neoadjuvant imatinib by sequencing of endoscopic ultrasound-biopsies
Per Hedenström, Bengt Nilsson, Akif Demir, Carola Andersson, Fredrik Enlund, Ola Nilsson, Riadh Sadik
Per Hedenström, Riadh Sadik, Division of Medical Gastroenterology, Department of Internal Medicine, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden
Bengt Nilsson, Department of Surgery, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden
Akif Demir, Carola Andersson, Fredrik Enlund, Ola Nilsson, Department of Clinical Pathology and Genetics, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden
Author contributions: Hedenström P, Nilsson B, Nilsson O and Sadik R designed the research; Hedenström P, Nilsson B, Demir A, Andersson C, Enlund F, Nilsson O and Sadik R performed the research; Enlund F and Sadik R contributed new analytic tools; Hedenström P and Sadik R analyzed the data; Hedenström P wrote the paper.
Supported by The Health and Medical Care Committee of the Regional Executive Board, Region Västra Götaland, No. VGFOUREG-564381, No. VGFOUREG-665681 and No. VGFOUREG-373551; Sahlgrenska University Hospital, No. LUA-ALF 73830; and The Swedish Society of Medicine, No. SLS-404261 and No. SLS-325061.
Institutional review board statement: This study was reviewed and approved by the Regional Ethical Review Board of Gothenburg (Study code: Dnr 573-09/Dnr 1092-11).
Clinical trial registration statement: This study was registered at ClinicalTrials.gov (NCT02360839).
Informed consent statement: Written and verbal informed consent was obtained from the participating study subjects.
Conflict-of-interest statement: Per Hedenström, Bengt Nilsson, Akif Demir, Carola Andersson, Fredrik Enlund, Ola Nilsson, and Riadh Sadik declare no potential conflicts of interest relevant to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Riadh Sadik, Associate Professor, Division of Medical Gastroenterology, Department of Internal Medicine, Sahlgrenska University Hospital, Blå Stråket 3, S-413 45 Gothenburg, Sweden. riadh.sadik@vgregion.se
Telephone: +46-31-3421000 Fax: +46-31-827458
Received: January 25, 2017
Peer-review started: February 1, 2017
First decision: April 5, 2017
Revised: April 26, 2017
Accepted: June 18, 2017
Article in press: June 19, 2017
Published online: August 28, 2017
Processing time: 214 Days and 23.6 Hours
Core Tip

Core tip: Personalization of the management and treatment of gastrointestinal stromal tumors (GIST) requires an extensive characterization of individual tumors. Information on the tumor proliferation rate and the KIT- and platelet-derived growth factor alpha (PDGFRA)-mutation profile is essential. While endoscopic ultrasound (EUS)-FNA is reported to be suboptimal for the diagnosis of GIST, EUS-guided biopsy sampling (EUS-FNB) has not been evaluated for the characterization of GISTs. This prospective, long-term study showed that EUS-FNB was safe and highly accurate for the pretreatment diagnosis of GISTs, for the sequencing of KIT and PDGFRA, and for the assessment of the tumor proliferation rate (Ki-67-index). By obtaining this information, we managed to guide and evaluate neoadjuvant imatinib therapy in patients with GIST.