Knowledge regarding the genomic changes in sarcoma is important for treatment decisions. Blood plasma of cancer patients has been shown to carry small amounts of fragmented circulating cell-free tumour DNA (ctDNA). The ctDNA represents in principle every cancer cell within the body. Using blood samples as a “liquid biopsy” allows new non-invasive means to obtain tumour material for molecular analyses of sarcoma (Namløs et al., Mol Aspects Med 2020). Liquid biopsies have received increased attention due to the obvious clinical implications for precision medicine. The presence and levels of ctDNA have been associated with a more aggressive cancer disease. Liquid biopsies can be collected in a diagnostic or prognostic setting or collected sequentially for real-time monitoring of treatment response and resistance to therapy and to monitor tumour evolution.

Most metastatic GIST patients experience progression when treated with tyrosine kinase inhibitors. There is a medical need to achieve more durable therapeutic responses. This can be accomplished by revealing the underlying mechanisms of drug resistance in light of the complexity of the tumour.

We aim to reveal the mechanisms that GIST cells use to escape the imatinib treatment, and thus improve the treatment of advanced GISTs. We also aim to provide better stratification of high-risk patients. This will be addressed through several project.