How do you approach non-surgical patients with GIST who are intolerant to imatinib 400 mg daily and unlikely to tolerate other TKIs?   

This is an excellent and common question. My general approach is to try to keep them on imatinib for as long as possible, working with dose/schedule modifications. Patients should, of course, have failed supportive care measures such as creams for hand/foot. I will reduce dose to 200mg daily, if th...

Great question!  I usually try splitting it first: 200 in the am and 200 in the pm. I also aggressively manage side effects.  If still a problem, I may have to reduce the dose.