GIST “What I Learned This Year” Quiz

According to the Introduction to Gastrointestinal Stromal Tumors video, which specific incidental GIST finding (<2cm) has a recommended management different from typical surveillance of small gastric/duodenal lesions?

Gastric nodule

Duodenal nodule

Rectal nodule

Esophageal nodule

According to the Introduction to Gastrointestinal Stromal Tumors video, which of the following is accurate regarding GIST risk factors?

Smoking is a well-known risk factor

Environmental exposures are primary drivers

There are no well-known lifestyle or environmental causes

Obesity is a significant risk factor

According to the Tools for the Diagnosis and Treatment of GIST video, what is the most common gain of function mutation found in GIST patients, for which imatinib is typically an effective frontline therapy?

PDGFR exon 18

SDH deficient tumors

BRAF mutation

KIT exon 11

According to the Tools for the Diagnosis and Treatment of GIST video, which specific GIST mutation is highlighted as being completely resistant to imatinib therapy?

KIT exon 9

KIT exon 11

PDGFR D842V

PDGFR non-D842V

According to the Treating a Patient Newly Diagnosed With GIST case study, when would a tissue biopsy typically be recommended before upfront surgical resection for a suspected GIST?

When the patient presents with early satiety

If there is concern for significant morbidity with upfront surgery given tumor location and size

For all tumors greater than 10 cm in size

If the tumor tests negative for CD117

Based on the Treating a Patient Newly Diagnosed With GIST case study, what is considered essential during GIST evaluation primarily because these tumors may be highly responsive to specific targeted therapies rather than chemotherapy?

Routine assessment of melena severity

Detailed family history of GI cancers

Calculation of risk stratification score using only tumor size and site

Obtaining additional sequencing information using a broad-panel platform

According to the Surgical Considerations and Challenges When Treating GIST video, what is the usual first line of treatment considered for a GIST tumor larger than five centimeters?

Direct surgical resection

Observation

Neoadjuvant therapy

Palliative care

According to the Surgical Considerations and Challenges When Treating GIST video, is routine lymph node dissection typically performed during surgical resection of GIST?

Yes, for all GIST surgeries

Yes, only for high-risk GIST

No, GIST usually does not spread to lymph nodes

Palliative care

According to the Considerations, Challenges, and Opportunities in the Palliative and Metastatic Setting video, which of the following surgical approaches for a bleeding large gastric GIST is LEAST likely to be a primary goal, even in urgent conditions?

Sleeve gastrectomy

Partial gastrectomy

Gastrectomy to achieve maximum margin

Organ preservation

According to the Considerations, Challenges, and Opportunities in the Palliative and Metastatic Setting video, in a metastatic GIST patient on imatinib therapy showing stable disease but growth in resistant clones, what is the unique primary purpose of tumor debulking surgery?

To facilitate a switch to a new line of therapy

To achieve a complete (R0) resection of all disease

To remove resistant clones to allow continuation of the current imatinib therapy

To diagnose the specific mechanism of resistance.

According to the Biomarker Testing for Genetic Evaluation of GISTs case study, for which specific mutation is imatinib 800 mg daily the preferred dose?

KIT exon 11 mutation

KIT exon 9 mutation

PDGFRA D842V mutation

KIT exon 13 V654A mutation

Based on the Biomarker Testing for Genetic Evaluation of GISTs case study, what crucial step is important when a GIST progresses on TKI therapy?

Increasing the current TKI dose

Switching directly to the next approved TKI

Performing a repeat biopsy and tumor sequencing

Initiating chemotherapy

According to the Frontline Therapies for the Treatment of GIST video, which laboratory tests are particularly important to monitor for patients starting imatinib therapy to check for potential asymptomatic side effects like anemia or organ dysfunction?

Thyroid Stimulating Hormone (TSH)

Serum Creatine Kinase (CK)

Complete Blood Count (CBC) and Complete Metabolic Panel (CMP)

Prothrombin Time (PT) and International Normalized Ratio (INR)

According to the Additional Therapies for the Treatment of GIST video, avapritinib, used for the imatinib-resistant PDGFR mutation, is particularly noted for its distinct risk of cognitive effects.

True

False

According to the Management of Side Effects Associated With GIST Therapies case study, what is the recommended management for a patient experiencing significant myelosuppression while on imatinib for GIST?

Continue imatinib at the current dose

Hold imatinib until counts normalize, then restart at a lower dose

Immediately reduce the imatinib dose

Switch to a different GIST therapy

According to the Management of Side Effects Associated With GIST Therapies case study, what is a recommended prophylaxis strategy to help prevent Hand-Foot Skin Reaction (HFSR) when starting subsequent-line GIST therapies (e.g., sunitinib, regorafenib)?

Routine use of systemic anti-inflammatory drugs

Limiting exposure to sunlight

Twice daily use of a topical keratinolytic agent like urea cream

Regular physical therapy for hands and feet

According to the Nutritional Challenges in Patients With GIST video, which nutritional deficiency is specifically mentioned as a potential concern after a Whipple procedure for GIST?

Carbohydrate malabsorption

Vitamin C deficiency

Fat malabsorption

Protein deficiency

According to the Nutritional Challenges in Patients With GIST video, the long-term impact of unresolved nutritional challenges in GIST patients receiving ongoing therapy includes increased difficulty completing treatment and a higher rate of hospital admissions.

True

False

According to The Vital Role of Supportive Care in GIST Patient Care video, which supportive care team member is most often challenged by the lack of sufficient external community resources when addressing logistical barriers for patients?

Nurse Navigator

Behavioral Health Colleague

Social Worker/Case Manager

Nutritionist

According to The Vital Role of Supportive Care in GIST Patient Care video, beyond philanthropy and institutional priority, what specific financial mechanism is mentioned as a strategy to support billing or reimbursement for navigation services in cancer care settings?

Establishing block grants for supportive care departments

Advocating for increased capitation payments for oncology practices

Implementing new navigation billing codes

Securing dedicated federal research funding for supportive care models