The mechanisms of imatinib resistance in gastrointestinal stromal tumours: Theoretical basis and therapeutic aspect

Imatinib, a small molecule inhibiting KIT and PDGFRA, was approved in 2002 for advanced GISTs. However, resistance develops, causing 50% of patients to relapse within 2–5 years. This review summarizes resistance mechanisms, including alterations in signaling pathways and disrupted autophagy/glycolysis. It also explores strategies to overcome resistance, such as the role of microRNAs, immunotherapy, and combination therapies, examining clinical trials to enhance the prognosis for advanced GIST patients.