Kubota Tetsuro
Center for Comprehensive and Advanced Medicine, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Int J Clin Oncol. 2006 Jun;11(3):184-9. doi: 10.1007/s10147-006-0579-0.
Imatinib mesylate is the first and only effective drug for the treatment of gastrointestinal stromal tumor at present. Mutated exon 11 of the KIT receptor is essential for the pathogenesis and response to imatinib mesylate of gastrointestinal stromal tumor; the efficacy rate (complete response+partial response) of imatinib mesylate is 53.8%, and the disease-control rate (complete response+partial response+stable disease) is 84%. Almost 90% of patients experienced non-hematological and hematological adverse effects, which were tolerable, in particular at a daily dose of 400 mg imatinib mesylate, which warranted response induction for half of the patients, and is the dose approved by Japanese medical insurance. Clinical trials suggest that an increased dose of imatinib mesylate would be beneficial, and that the interruption of imatinib treatment might result in disease progression even after a partial response. Tentative Japanese guidelines for the diagnosis and therapy of gastrointestinal stromal tumors are being prepared by the Gastrointestinal Stromal Tumor Committee of the Japan Society of Clinical Oncology, and are presented here for critical comments by colleagues.
甲磺酸伊马替尼是目前治疗胃肠道间质瘤的首个也是唯一有效的药物。KIT受体第11外显子突变对于胃肠道间质瘤的发病机制及对甲磺酸伊马替尼的反应至关重要；甲磺酸伊马替尼的有效率（完全缓解+部分缓解）为53.8%，疾病控制率（完全缓解+部分缓解+病情稳定）为84%。几乎90%的患者出现了非血液学和血液学不良反应，这些不良反应是可耐受的，尤其是在甲磺酸伊马替尼每日剂量为400 mg时，该剂量使一半患者获得反应诱导，且是日本医疗保险批准的剂量。临床试验表明，增加甲磺酸伊马替尼的剂量可能有益，并且即使在部分缓解后中断伊马替尼治疗也可能导致疾病进展。日本临床肿瘤学会胃肠道间质瘤委员会正在制定胃肠道间质瘤诊断和治疗的暂行日本指南，在此展示以供同行提出批判性意见。
