OPINION Everything on this page was said in a consultation or call, not written in a signed document; it is the doctor's view, not an established fact. How to read the tags
Before the 05.10.2026 procedures. This call took place before the laparoscopy, the biopsies and the ascitic-fluid cytology, so none of it takes those results into account (current status). Opinions given in a phone call; no written conclusion or prescription was issued. Summary of the key statements only; the call is not published.
Key statements (opinion)
- Regorafenib (the family said she would receive it the next day, 30.09.2026): "not a bad choice". It was already chosen at LISOD; she did not prescribe it.
- Local treatment of the liver foci (surgery, ablation or embolisation with imatinib continued): "not a standard approach"; her centre does not give such individualised treatment. With multiple liver metastases her centre does not recommend surgery.
- Standard path after imatinib failure: palliative treatment with next-line drugs. In Poland sunitinib is used; regorafenib is not available there.
- Agreed that sunitinib is "not really active" against the exon 18 A829P mutation.
- Ripretinib: "very expensive" (no further comment).
- Progression-free time on any later line is shorter than on imatinib ("that's how this disease looks").
- Treatment in Poland requires Polish state insurance.
- If local treatment is pursued: liver-surgery centres rather than GIST or oncology clinics (liver surgeons also perform chemoembolisation). Named: Prof. M. Grąt and Dr hab. O. Kornasiewicz (liver surgery, Warsaw), the Military Institute of Medicine (Warsaw), CyberKnife stereotactic radiotherapy (Dr M. Szyburski, Warsaw), SIRT at the National Institute of Oncology, Gliwice.
- No clinical trials or next-generation TKIs were proposed.