News from GI ASCO

There was some great stuff that came out of GI ASCO last week. Here is the one I was most excited about.

This small, single center, phase II study indicates that sorafenib appears to be modestly useful after imatinib and sunitinib for gastrointestinal stromal tumors which have become refractory. Sorafenib had a stable disease rate of 55% and a response rate of 17%, which, if shown to be effective in a larger randomized trial, would be in keeping with other therapies for GIST. I hope that they take this study on to a larger phase II or III study, as we definitely need more treatments for these patients, many of whom live many good, productive years with their disease. I have patients still in my practice with metastatic GIST who I started with the first year of my faculty appointment in 2006! The one critique of this study is that they included both sunitinib–sensitive and –resistant patients, which muddies the waters. In the next study, I hope they stick with only third–line patients who are truly refractory to both medications. Side effects have to be reasonable as well since I believe sorafenib can be sometimes difficult to tolerate in poor performance status or heavily pretreated patients with rash, hand-foot syndrome and fatigue.