Clinical significance of surgical intervention for imatinib-resistant gastrointestinal stromal tumors in the era of multiple tyrosine kinase inhibitors.
Adult
Aged
Aged, 80 and over
Drug Resistance, Neoplasm
Female
Gastrointestinal Neoplasms
/ drug therapy
Gastrointestinal Stromal Tumors
/ drug therapy
Humans
Imatinib Mesylate
/ therapeutic use
Male
Middle Aged
Protein Kinase Inhibitors
/ pharmacology
Protein-Tyrosine Kinases
/ antagonists & inhibitors
Retrospective Studies
Survival Rate
Treatment Outcome
Gastrointestinal stromal tumor
Imatinib-resistance
Surgical intervention
Journal
Surgery today
ISSN: 1436-2813
Titre abrégé: Surg Today
Pays: Japan
ID NLM: 9204360
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
01
11
2020
accepted:
11
01
2021
pubmed:
12
2
2021
medline:
18
12
2021
entrez:
11
2
2021
Statut:
ppublish
Résumé
Imatinib is the standard treatment for unresectable and metastatic GIST. In the late stages, patients undergoing imatinib show drug resistance. Surgical intervention has been occasionally performed for resistant lesions. However, the clinical significance of such intervention remains unclear. Between 2006 and 2015, 37 patients were diagnosed with imatinib-resistant GISTs. We performed surgical intervention only for localized resistant lesions. We retrospectively investigated the background characteristics, data on surgical intervention and subsequent treatment, progression-free survival (PFS), and overall survival (OS). Eighteen patients diagnosed with localized resistance received surgical intervention (S-group) and 19 patients diagnosed with generalized resistance were received other TKIs (M-group). In S-group, no serious complications occurred, and all patients restarted imatinib after resection. The median PFS was 14.5 months. Five patients underwent surgical intervention multiple times followed by the continuation of imatinib, and the median duration of imatinib continuation was 22.2 months. Second-line TKIs were administered to 93% of the patients and the dose-intensity and outcome were similar in both groups. The median OS was 47.2 months after surgery. Surgical intervention could be performed safely and therefore could be followed by the continuation of TKI therapy. Surgical intervention based on the appropriate criteria of resistance might thus be useful for imatinib-resistant GISTs.
Identifiants
pubmed: 33570662
doi: 10.1007/s00595-021-02241-5
pii: 10.1007/s00595-021-02241-5
doi:
Substances chimiques
Protein Kinase Inhibitors
0
Imatinib Mesylate
8A1O1M485B
Protein-Tyrosine Kinases
EC 2.7.10.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1506-1512Informations de copyright
© 2021. Springer Nature Singapore Pte Ltd.
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