by Gabriella Tedone
The 3rd National Italian Meeting of A.I.G. (Associazione Italiana GIST) took place at Fondazione IRCCS Istituto Nazionale dei Tumori (INT), in Milan, Italy, on Saturday, February 27, 2010. For the 99 patients and caregivers attending the meeting it was a great opportunity of hearing lectures by the main Italian GIST experts, learning more about GIST and sharing issues and open topics with doctors. 13 speakers, various oncologists from INT, from University of Medicine, and 6 Novartis people attended the whole meeting and participated in the discussion with the audience.
A special thanks for his assistance with the meeting goes to Dr. Paolo Casali (Head of Sarcoma Dept. at INT, Milan). Dr. Casali is the referential oncologist of A.I.G. since its foundation. He focused on the present state of the art in targeted therapy, on strategies against primary and secondary resistance, on molecular heterogeneity and new target therapies and rechallenge with imatinib.
Achieved goals of the meeting included:
- patients have been well informed about the importance of correct diagnosis and about what is required to perform and guarantee it (morphological, phenotypic, and molecular characterizations; differential diagnosis (DD); competence/experience), and additionally, about the predictive role of mutational analysis of KIT /PDGFRA
- the conference focused patients’ attention on molecular genetics, that is of utmost importance for diagnosis, prognosis and predictivity
- attendees learned that molecular medicine is a broad field whose objectives can be summarized in four "Ps": Preventive, Predictive, Personalized, Participated Medicine (because of the more and more relevant importance of advocacy groups) – said Doctor M. Pierotti, scientific manager at INT, in Milan
Special topics were discussed by experts and appreciated by the audience.
Dr. Morelli (Manager of Laboratory Medicine at INT, Milan) talked about the starting of the first Lab testing the clinical significance of imatinib plasma levels – an observational study in INT evaluating correlations between SNPs, Imatinib plasma levels and responsiveness to drug.
All patients were particularly interested in presentations given by Dr. Fausto Catena and Dr. Maria A. Pantaleo, both from Policlinico S.Orsola-Malpighi, Bologna. Dr. Catena discussed the Surgery of primary and localized disease – open surgery or laparoscopic surgery.
Doctor M. Pantaleo focused on Imatinib adjuvant therapy and open issues: which patients should be treated, dose and duration. She pointed out that there is no unique decision: low risk GISTs should receive no adjuvant Gleevec, opposite to high risk who have a strong indication for it. Intermediate risk patients should be examined case by case, based on Miettinen risk classification, with decision making resulting from dynamic and interactive process, involving both patient and oncologist, who has to examine many factors: patient’s expectation, age, concomitant diseases, mutation, site, surgical procedure, compliance, other factors.
The expert clinicians — oncologists, pathologists, and surgeons — were very involved in discussions with people attending the meeting, answering all of patients’ questions about side effects of specific drugs, off-label drugs, drug trials and approaches against resistance. The contribution of these professionals was greatly appreciated by the audience.
Anna Costato, Chairwoman of A.I.G. is the organizer for the meeting. She greeted all doctors who attended the meeting on their own time and expense and Novartis for supporting constantly the A.I.G.. She announced that in this year four meeting, with doctors and patients, will be organized by Novartis around Italy, and several teleconferences among doctors and patients on critical issues about GIST. She addressed all participants about importance of compliance with therapy.
For more information, see the A.I.G website, where one can view the slides used by the presenters (in Italian, of course).
