Kasper Bernd, Kallinowski Birgit, Herrmann Thomas, Lehnert Thomas, Mechtersheimer Gunhild, Geer Thomas, Ho Anthony D, Egerer Gerlinde
Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.
Dig Dis. 2006;24(1-2):207-11. doi: 10.1159/000090322.
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Surgery has been the only effective therapy. However, many patients still eventually die of disease recurrence. Chemotherapy and radiation therapy have been of limited value. Imatinib mesylate (Glivec) is an orally administered competitive inhibitor of tyrosine kinases associated with the KIT, ABL protein, licensed for the treatment of metastatic GIST since 2002 in Germany.
We summarized the data of 16 patients with advanced or metastatic GIST treated with imatinib mesylate in palliative and neoadjuvant settings.
Overall response was 81%, with no evidence of disease (NED) in 3/16 (19%), partial response (PR) in 9/16 (56%) and stable disease (SD) in 1/16 (6%), whereas 3/16 patients (19%) suffered from progressive disease (PD). Mean follow-up was 18.6 months [range: 4-30]. Mean progression-free survival (PFS) was 17.6 months [range: 0-30], mean overall survival (OS) from initial diagnosis was 32.3 months [range: 5-122]. Most common side effects were periorbital edema and skin rash.
Imatinib mesylate is well tolerated in a dose of up to 800 mg/day and has significant activity during long- term treatment of patients with advanced or metastatic GIST.
胃肠道间质瘤(GIST)是胃肠道最常见的间叶性肿瘤。手术一直是唯一有效的治疗方法。然而,许多患者最终仍死于疾病复发。化疗和放疗的价值有限。甲磺酸伊马替尼(格列卫)是一种口服的酪氨酸激酶竞争性抑制剂,与KIT、ABL蛋白相关,自2002年起在德国被批准用于治疗转移性GIST。
我们总结了16例晚期或转移性GIST患者在姑息和新辅助治疗中接受甲磺酸伊马替尼治疗的数据。
总体缓解率为81%,16例中有3例(19%)达到疾病无证据(NED),9例(56%)部分缓解(PR),1例(6%)疾病稳定(SD),而16例中有3例(19%)疾病进展(PD)。平均随访时间为18.6个月[范围:4 - 30个月]。平均无进展生存期(PFS)为17.6个月[范围:0 - 30个月],从初始诊断起的平均总生存期(OS)为32.3个月[范围:5 - 122个月]。最常见的副作用是眶周水肿和皮疹。
甲磺酸伊马替尼在每日剂量高达800 mg时耐受性良好,在晚期或转移性GIST患者的长期治疗中具有显著活性。