Sunitinib versus imatinib dose escalation after failure of imatinib standard dose in patients with advanced Gastrointestinal stromal tumors – a real-world multi-center study

•1.Escalating imatinib dosage or directly switch to sunitinib in GISTs failing on standard dose of imatinib is still controversial.•2.After the progression of imatinib standard-dose treatment in recurrent/metastatic GISTs, the progression-free survival (PFS) of patients directly switching to sunitinib was significantly longer compared with the PFS of patients with imatinib dose escalation in our study.•3.Sunitinib was a more effective TKI with an improved PFS for GISTs after the progression of standard dose of imatinib.•4.Under the circumstance that the overall survival (OS) in the two groups was similar, it was suggested that the curative effect of imatinib dose escalation followed by sunitinib was also considerable, and we could not deny its feasibility.