甲磺酸伊马替尼治疗期间转移性腺样囊性癌意外快速进展
Unexpected rapid progression of metastatic adenoid cystic carcinoma during treatment with imatinib mesylate.
作者信息
Lin Ching-Hung, Yen Roh-Fan, Jeng Yung-Ming, Tzen Chin-Yuan, Hsu Chiun, Hong Ruey-Long
机构信息
Department of Oncology, National Taiwan University Hospital, National Taiwan University, No 7, Chung-Shan South Rd, Taipei 10016, Taiwan.
出版信息
Head Neck. 2005 Dec;27(12):1022-7. doi: 10.1002/hed.20274.
BACKGROUND
There is a lack of effective treatment for metastatic adenoid cystic carcinoma (ACC), a usually indolent tumor. We studied the efficacy of imatinib mesylate, a potent inhibitor of KIT tyrosine kinase, in patients with KIT-positive metastatic ACC.
METHOD
Five patients with lung metastasis were treated in a pilot study with imatinib 400 mg by mouth twice a day. Mutations of c-kit and platelet-derived growth factor receptor (PDGFR)-alpha in tumors from these patients were analyzed.
RESULTS
Disease progression was noted in three of five patients during the short treatment periods, ranging from 2 to 3 weeks. Three patients died of disease within 6 months. No detectable mutations were found in c-kit and PDGFR-alpha.
CONCLUSION
We observed an unexpected high progression rate of metastatic ACC within short periods during imatinib treatment. Use of imatinib to treat cancers without c-kit or PDGFR-alpha mutation should be approached with caution.
背景
转移性腺样囊性癌（ACC）通常是一种生长缓慢的肿瘤，目前缺乏有效的治疗方法。我们研究了KIT酪氨酸激酶的强效抑制剂甲磺酸伊马替尼对KIT阳性转移性ACC患者的疗效。
方法
在一项初步研究中，对5例肺转移患者采用每日口服两次400 mg伊马替尼进行治疗。分析了这些患者肿瘤中c-kit和血小板衍生生长因子受体（PDGFR）-α的突变情况。
结果
在2至3周的短治疗期内，5例患者中有3例出现疾病进展。3例患者在6个月内死于疾病。未在c-kit和PDGFR-α中发现可检测到的突变。
结论
我们观察到在伊马替尼治疗期间，转移性ACC在短时间内出现了意外的高进展率。在治疗无c-kit或PDGFR-α突变的癌症时，应谨慎使用伊马替尼。
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