Marta Berndsen: Reduced follow-up may be sufficient for many GIST patients
Gastrointestinal stromal tumors (GIST) are a type of cancer for which patients in Sweden currently are recommended frequent and long-term follow-up. Marta Berndsen's research suggests that fewer checkups may be sufficient for less aggressive GIST cases, potentially reducing both stress and radiation exposure for patients.
MARTA BERNDSEN
Dissertation defense: 6 December 2024 (click for details)
Doctoral thesis: Translational aspects of Gastrointestinal stromal tumors
Research area: Surgery
Sahlgrenska Academy, The Institute of Clinical Sciences
Gastrointestinal stromal tumors, or GIST, are the most common type of soft tissue sarcoma in the digestive tract. They typically develop in the stomach or small intestine and can vary widely in aggressiveness.
Marta Berndsen is a surgeon in the Department of Endocrine and Abdominal Sarcoma at Sahlgrenska University Hospital and a doctoral student at the Institute of Clinical Sciences. In her thesis, she has evaluated various treatment methods and followed GIST patients in Sweden and other Nordic countries.
“The aim was to improve GIST treatment and follow-up by investigating whether circulating tumor DNA can be detected in GIST patients, and to assess the potential of two alternative treatment methods. We also reviewed extensive Nordic patient data to determine which patients require extensive follow-up after surgery,” says Marta Berndsen.
Questioning current follow-up practices
Marta Berndsen and her research team reviewed a large Nordic dataset of patients with less aggressive GIST. They found that the risk of recurrence after surgery is extremely low.
“Therefore, we question the recommendation that all GIST patients need frequent and long-term follow-ups with CT scans. This can cause stress and expose patients to unnecessary radiation.”
Potential new treatment methods
What else did you find?
“Circulating tumor DNA appears to be difficult to detect in less aggressive GIST cases, but it may be useful for patients with more severe forms of the disease,” says Marta Berndsen and adds:
“The expression of a type of protein receptor called GRPR was found to be high in most GIST cases. This suggests that GIST could be treated with a form of internal radiation therapy that targets the GRPR receptor. We also examined the expression of proteins SDHB and MGMT. GIST tumors lacking these proteins might respond to temozolomide, a drug used for other cancers, such as brain tumors.”
Collaboration with Nordic colleagues
What has been the most rewarding part of the doctoral project?
“Learning new things and gaining insight into how our patients are doing over time has been incredibly rewarding. It has also been very fulfilling to work with other professionals and researchers at institutions in Sweden and across the Nordic region.”
And the most challenging part?
“Finding time for research within a busy clinical schedule. As a surgeon, you never want to be away from clinical practice for too long, so research has often been done during evenings and weekends.”
Text: Jakob Lundberg