Vatalanib (PTK787/ZK 222584; Bayer Schering Pharma AG, Berlin; Novartis, East Hanover, NJ, USA) is an oral tyrosine kinase inhibitor (TKI) that inhibits the two key kinases that are often mutated in GIST, KIT and the platelet-derived growth factor receptor-α (PDGFRα), and all three isoforms of the vascular endothelial growth factor receptors (VEGFR-1 [Flt-1], VEGFR-2 [KDR] and VEGFR-3 [Flt-4]) (Wood et al, 2000). This evidence concerns the gene FLT4 and gastrointestinal stromal tumor.