gastrointestinal stromal tumor

The release also includes updates to the CAP breast biomarker protocol, including revisions to estrogen receptor, progesterone receptor, and HER2 scoring and reporting criteria.

The CAP also expanded molecular testing and reporting within its gastrointestinal stromal tumor, or GIST, protocols.

The revised protocols now include reporting for GIST tumors across all sites where they commonly occur.

For every 1,000 patients with lung cancer who are eligible for precision care, less than half receive it.

Those discouraging results from a 2022 analysis in JCO Precision Oncology form the framework for a CAP26 opening session on the care gap in precision oncology.

And I'll talk in general terms, but again, because there are some specific sarcomas that might not apply to.

But in general, for early stage disease, excluding GIST, we're not talking about gastrointestinal stromal tumors, just the other sarcomas.

Early stage disease, the histological subtype classification is very important.

And the pathologist usually will run certain panels.

We have ESMO after that.

Like, what should the world be looking for specifically for sarcoma in the next couple of years?

I think, you know, I kind of break it down into, say, for just see more if there's a lot of area of interest in exploring how to tackle secondary mutations or resistance mechanisms in GIST and newer therapies that are more targeted to the GIST alterations.

So you will see here at ASCO this year, some combination therapy that might be practice changing or is practice changing in my opinion, but we'll see all the data at ASCO.

The patient requires targeted adjuvant therapy.

GISTs are driven by a specific mutation in the c-kit proto-oncogene, a tyrosine kinase receptor.

The revolutionary treatment is imatinib, a tyrosine kinase inhibitor, which the patient must take for three or more years post-operatively to suppress the microscopic disease.

Then we have lymphoma.

The highly targeted revolutionary treatment is the specific tyrosine kinase inhibitor, imatinib.

That brings us to GISTs, gastrointestinal stromal tumors, which also rely on targeted therapy.

GISTs are unique.

They arise directly from the interstitial cells of Cajal, which are the specialized neurological pacemaker cells of the gut that coordinate peristalsis.

Endoscopically, they look very distinct.

That brings me to a final provocative thought for all of you listening to mull over as you head into the wards.

We’ve talked extensively today about these massive life-altering anatomical resections, total gastrectomies, D2 dissections stripping the retroperitoneum, Ivor-Lewis esophagectomies.

But we also touched on highly targeted cellular therapies like using imatinib for GISTs based solely on the c-KIT mutation, or curing a MALToma lymphoma entirely with a simple course of antibiotics.

But there are also some off-label options.

Imatinib, we know this drug very well from CML and GIST, but it is also somewhat weaker, but still sees a 1R inhibitor and it's an oral drug as well.

So it's being used quite often in the setting of TGCT.

Nilotinib is another sees a 1R inhibitor used in chronic myeloid leukemia and is sometimes used as well for this disease.

As I said, already during the single agent dose escalation for 1808, we saw complete responses in ovarian cancer.

We saw a partial response, which later became a complete response in GIST.

We saw a partial response in non-small cell lung cancer and lots of disease stabilizations.

And those were all patients that have been heavily, heavily pre-treated, typical phase one unit patients.

Another story.

This is the last one I'll share is the GIST tumor patient.

You know that one.

Right.

But we were able to use some of the staples that we brought from the United States.

And that kind of sped things up a little bit.

But the patient survived and the patient actually ended up having a very advanced stage of GIST, but ended up living...

I think two more years.