The treatment of advanced gastrointestinal stromal tumours (GIST) has shifted since the
arrival of targeted therapies. Imatinib is an active multikinase inhibitor that mainly
targets C-kit tyrosine-kinase receptors and the platelet-derived growth factor receptor.
Imatinib use has been validated for adjuvant and palliative therapy settings. Imatinib is
generally well-tolerated and known to improve performance status but up to 16% grades 3-4
toxicities, leading to at least 40% withdrawals, have been reported.
Recently, in oncology, sarcopenia was shown to be a predictor of severe toxicity patients
included in phase 1 trials, suggesting that it should be considered an inclusion criterion
for such studies. Sarcopenic patients had low performance status, shorter survival, more
chemotherapy toxicities and post-operative infections, and longer post-operative
hospitalization times. In addition, exposure to tyrosine-kinase inhibitors (e.g. sorafenib or
sunitinib) has been associated with dose-limiting toxicity (DLT) in patients with renal cell
or hepatocellular carcinomas.
Computed tomography (CT) scans acquired during routine care have been validated as an
accurate and robust imaging technique to evaluate sarcopenia in cancer patients.