Side effects from tyrosine kinase inhibitors (TKIs) in patients with gastrointestinal stromal tumors (GISTs) might be underreported, given that treatment adjustments are often needed to maintain patients’ health-related quality of life (HRQoL), according to a new study published in Cancers. Researchers reviewed the available literature on HRQoL and side effects in patients with GIST undergoing TKI therapy.

“This review showed that most TKI treated GIST patients experience side effects, mostly mild to moderate, which did not seem to affect overall HRQoL,” the authors wrote. “However, in daily clinical practice, side effects and their impact on the daily lives of patients are the main reason for dose reductions, dose interruptions, and schedule modifications.”

Because of the use of TKIs in the last 2 decades, gains in median survival have led to the need for a more comprehensive assessment of HRQoL in the growing population of individuals living with GISTs. However, studies on HRQoL in patients who are on TKI treatment are lacking, despite the ever-increasing use of this treatment approach.


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The authors reviewed HRQoL outcomes and side effects from TKI treatment in 104 papers reporting on the use of imatinib, regorafenib, ripretinib, and sunitibib in patients with GISTs. Despite not finding a severe impact of TKI side effects on HRQoL in these patients, they did find that in clinical practice side effects frequently lead to the need for treatment adjustments including interruptions and dose and schedule changes.

The authors suspect that either the side effects are underestimated by physicians, or that current HRQoL measurements are not sufficiently sensitive to all of the relevant issues experienced by patients with GISTs.

Therefore, the authors recommend a more multidisciplinary approach to detecting and measuring symptoms, side effects, and issues related to HRQoL among patients with GISTs undergoing TKI treatment.

Reference

van de Wal D, Elie M, Le Cesne A, et al. Health-related quality of life and side effects in gastrointestinal stromal tumor (GIST) patients treated with tyrosine kinase inhibitors: a systematic review of the literature. Cancers. 2022;14(7):1832. doi:10.3390/cancers14071832