Yamamoto Satoshi, Kubo Shoji, Shuto Taichi, Yamamoto Takatsugu, Hirohashi Kazuhiro, Tanaka Hiromu, Takemura Shigekazu, Kanazawa Akishige, Kinoshita Hiroaki
Department of Gastroenterological and Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
J Gastroenterol. 2003;38(9):896-9. doi: 10.1007/s00535-002-1168-2.
Gastrointestinal stromal tumors (GISTs) are usually refractory to standard chemotherapeutic agents. We successfully treated a patient with a tyrosine kinase inhibitor (STI571) for GIST with peritoneal dissemination and liver metastases.
In a 32-year-old man presenting with abdominal pain from diffuse peritonitis, a GIST and associated perforated small intestine were resected. Multiple liver metastases were present. After therapies with microwave coagulation, ethanol injection, and local and systemic antineoplastic drugs (fluorouracil, cisplatin, tegafur-uracil, and tegafur) failed, investigational treatment with a tyrosine kinase inhibitor was initiated (STI571, 300 mg, p.o. daily).
Anorexia and abdominal fullness resolved within a few days. At 24 days after initiation, positron emission tomography showed a remarkable decrease in the abdominal uptake of [18F] fluorodeoxyglucose. Adverse effects of STI571, including mild alopecia and anemia, were minimal.
The tyrosine kinase inhibitor STI571 may be effective against GISTs.
