Recently, GIST discussion groups have debated the value of the LRG study that examined dosage levels and survival rates. It is important for us to have this debate in the patient community; yet it is equally necessary to spur debate among scientists and physicians. But we should be clear about what exactly we are debating. No current study, neither the MetaGIST Project study nor the LRG study, can offer definitive answers on the correct dosage levels of Gleevec, but both do provide information that can help us ask the right questions.

Since 2001 GIST treatment has benefited from blocking a single mutant protein, c-KIT. Targeting c-KIT with Gleevec and Sutent has led to years of extended survival for many GIST patients. Unfortunately cancer is an adaptive disease. Adaptive c-KIT mutations can bypass current therapies in one common mechanism of GIST resistance. As researchers observe this phenomenon, the need arises to seek and block new proteins in the GIST cell signaling pathway.