Written by Gabriella Tedone

The Third National Italian Meeting of A.I.G. (Associazione Italiana GIST) was held at Fondazione IRCCS Istituto Nazionale dei Tumori (INT), in Milan on Saturday, February 27, 2010.

For the 99 patients and caregivers attending the meeting, it was a great opportunity to hear lectures by the main Italian GIST experts, learn more about GIST, and share issues and open topics with doctors. Thirteen speakers, various oncologists from INT and the University of Medicine, and six Novartis representatives attended the meeting and participated in the discussion with the audience.

The meeting focused on molecular genetics, of utmost importance for diagnosis, prognosis and prediction.

Many goals were also achieved. Patients have been well informed about importance of correct diagnosis and about what is requested to perform and guarantee it and the predictive role of mutational analysis of KIT / PDGFRA.

Dr. M. Pierotti, scientific manager at INT, said molecular medicine is a broad field whose objectives can be summarized in four “Ps”: Preventive, Predictive, Personalized, and Participatory Medicine (because of the more and more relevant importance of advocacy groups).

Special topics were presented, including one by Dr. A. Gronchi (surgeon at INT, Milan) on a new European, Australian and New Zealand trial (EORTC62063) evaluating “Surgery of Residual Disease in Patients With Metastatic Gastrointestinal Stromal Tumor Responding to Imatinib Mesylate”; the second by Dr. D. Morelli (Manager of Laboratory Medicine at INT, Milan) about the starting of the first lab testing the clinical significance of imatinib plasma levels – an observational study in INT evaluating correlations between SNPs, imatinib plasma levels and responsiveness to drug.

Patients were especially interested in presentations by Dr. Fausto Catena and Dr. Maria A. Pantaleo. Dr. Catena discussed the surgery of primary and localized disease, open surgery or laparoscopic surgery. Dr. Pantaleo focused on imatinib adjuvant therapy and open issues, such as which patients should be treated, along with dose and duration. She stated that low risk GISTs should not receive adjuvant Gleevec and high risk GISTs have a strong indication for it. Intermediate risks should be examined case by case, based on Miettinen risk classification with decisions resulting from dynamic and interactive processes. The oncologist has to examine many factors including the patient’s expectation, age, concomitant diseases, mutation, site, intermediate risk, surgical procedure and compliance.

The clinicians at the meeting were very involved and answered all of the patients’ questions regarding side-effects of specific drugs, off label drugs, drug trials and approaches against resistance. Their contribution was greatly appreciated by the audience.

A special thanks to Dr. Paolo Casali, the head of the Sarcoma Dept. at INT, Milan.