<qa>  What is the standard treatment of GIST?Complete resection, with or without associated anticancer therapy, is the standard treatment of GIST. Even though the prognosis of advanced GIST has been tremendously improved by the introduction of tyrosine kinase inhibitors TKI-imatinib, sunitinib..., the vast majority of patients will develop secondary resistance to these agents. The therapeutic options for patients with advanced GIST with resistance or intolerance to imatinib and sunitinib remain very limited. Some new molecules are currently being evaluated in patients with metastatic or locally advanced - imatinib-resistant disease. Nilotinib, for instance, has been evaluated in phase III trials and compassionate use programs with a median progression-free survival PFS close to 3 months and a median overall survival close to 8.5 months. A phase III trial comparing nilotinib vs. best supportive care BSC - imatinib or sunitinib investigators choice has just been completed and results are pending. Another molecule, Sorafenib, has been evaluated in 4th line treatment in compassionate use studies, with a median PFS close to 5 months and a median overall survival of 10-13 months. There are currently no recognized standard options after failure of 2nd line treatment, and the recently updated guidelines from the NCCN or ESMO 2009 suggest the possible reintroduction of TKI in an attempt to control the progression of sensitive cell clones. 