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4.3 Treatment after progression

Some GISTs grow while taking drug treatment.

Doctors call this cancer progression. Treatment

options after progression are presented next.

Chart 4.3.1

lists treatment options based on

whether there is limited or widespread growth.

If limited growth, you may keep taking imatinib

and consider local treatments. Otherwise, you may

increase the dose of imatinib or start taking sunitinib.

NCCN Guidelines for Patients


Soft Tissue Sarcoma, Version 1.2014



Gastrointestinal stromal tumors Treatment after progression

Chart 4.3.1 First progression

Cancer growth

Treatment options

Chart 4.3.2 Second progression

Treatment options

• Regorafenib

• Clinical trial

• Alternate treatments (little research done)

• Supportive care


Increase dose of imatinib

Change to sunitinib


Continue imatinib and consider:

• Surgery if possible

• Ablation, embolization, or chemoembolization

• Palliative radiation therapy if cancer spread to

your bones

Increase dose of imatinib or change to sunitinib