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General Medicine · Gastroenterology and hepatology: gastrointestinal stromal tumour
Sample itemA 58-year-old man presents with melaena. CT shows a 6 cm exophytic gastric mass. Histology shows spindle cells positive for CD117 and DOG1. Which drug is appropriate for unresectable disease?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Imatinib
Most gastrointestinal stromal tumours arise from the interstitial cells of Cajal and carry activating mutations of KIT (CD117) or PDGFRA. Imatinib inhibits these tyrosine kinases and is the standard drug for unresectable, metastatic or high-risk resected disease.
Option by option
A. Trastuzumab
Trastuzumab targets HER2, which is not the driver in these tumours.
B. Imatinib (correct)
Correct. Imatinib blocks the KIT tyrosine kinase that drives the tumour.
C. Rituximab
Rituximab targets CD20 on B cells and has no role in stromal tumours.
D. Cetuximab
Cetuximab targets EGFR and is used in colorectal and head and neck cancers.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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