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General Surgery · Stomach: GIST
Sample itemA 60-year-old has anaemia and a 6 cm submucosal gastric mass with central ulceration. Histology shows spindle cells positive for CD117 (KIT) and DOG1. What drug is used for advanced or high-risk disease?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Imatinib
Gastrointestinal stromal tumours arise from interstitial cells of Cajal and are driven by KIT or PDGFRA mutations. Surgical resection without lymphadenectomy is the primary treatment, and imatinib, a tyrosine kinase inhibitor, is used for metastatic or high-risk tumours. Conventional chemotherapy is largely ineffective.
Option by option
A. Tamoxifen
Tamoxifen is an anti-oestrogen used in breast cancer.
B. Cisplatin plus 5-fluorouracil alone
Classic cytotoxic regimens have poor activity in GIST.
C. Imatinib (correct)
Correct. Imatinib inhibits KIT and improves survival in GIST.
D. Methotrexate
Methotrexate is not an effective agent against GIST.
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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