Small, asymptomatic Gastrointestinal stromal tumor(GISTs) found in the course of tests for another condition may be approached with watchful waiting in carefully selected cases.
All large or symptomatic GISTs should be surgically removed unless they are too large or they involve too many organs and tissues for surgery (resection). Resection is also delayed or avoided in people whose general health makes any surgery too risky to undertake, as well as those likely to have metastatic GISTs.
It's often possible to resect GISTs using minimally invasive surgery, which involves inserting a viewing tube (laparoscope) and surgical instruments through small incisions in the abdomen.
Targeted drug therapy
GISTs do not respond to traditional chemotherapy. Thanks to recently gained understanding of tumor genetic changes in GISTs, however, drugs that interrupt the process of tumor spread have greatly improved the outlook for people with the disease.
Imatinib (Gleevec) is the first line medical treatment used to prevent GIST recurrence after surgery. The drug is also used in situations where surgery isn't possible, as well as in controlling recurrent GIST.
The current trend is to continue imatinib treatment as long as it's tolerated and it remains effective. Unfortunately, GISTs tend to become resistant to imatinib over time. A different targeted drug, sunitinib malate (Sutent) often works on imatinib-resistant GISTs. A number of other targeted drugs now in development are expected to join imatinib and sunitinib in coming years.