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酪氨酸激酶抑制在肾细胞癌和胃肠道间质瘤中的应用:病例报告

Tyrosine kinase inhibition in renal cell carcinoma and gastrointestinal stromal tumours: case reports.

作者信息

Schöffski P, Bukowski R, Flodgren P, Ravaud A

机构信息

Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Catholic University Leuven, Leuven, Belgium.

出版信息

Ann Oncol. 2009 May;20 Suppl 1:i25-i30. doi: 10.1093/annonc/mdp076.

Abstract

BACKGROUND

Sunitinib malate is approved multinationally for the treatment of metastatic renal cell carcinoma (mRCC) and advanced imatinib-refractory gastrointestinal stromal tumour (GIST). Greater exposure to sunitinib is associated with improved efficacy. Therefore, minimising the impact of adverse events (AEs) on patient quality of life is important to enable patients to achieve optimal exposure to sunitinib and maximum clinical benefit.

DESIGN

This report describes four patient cases in which sunitinib was utilised for the management of advanced malignancies: two cases describe mRCC patients who received first-line sunitinib and two cases describe the use of targeted therapies, including sunitinib, in patients with advanced GIST.

RESULTS

In all four cases, effective AE management enabled patients to receive long-term therapy with sunitinib and achieve sustained clinical benefit. The two mRCC cases show prolonged responses and manageable AEs with sunitinib. The two GIST cases demonstrate that patients with imatinib-refractory GIST with KIT exon 9 mutations, including elderly patients, can achieve sustained responses to sunitinib.

CONCLUSIONS

These case studies support the long-term efficacy and safety of sunitinib in the management of mRCC and imatinib-refractory GIST and demonstrate how AE management can be used to optimise patient responses.

摘要

背景

苹果酸舒尼替尼已在多国获批用于治疗转移性肾细胞癌(mRCC)和晚期伊马替尼难治性胃肠道间质瘤(GIST)。舒尼替尼的暴露量增加与疗效改善相关。因此,尽量减少不良事件(AE)对患者生活质量的影响对于使患者能够达到舒尼替尼的最佳暴露量并获得最大临床益处至关重要。

设计

本报告描述了4例使用舒尼替尼治疗晚期恶性肿瘤的患者病例:2例描述接受一线舒尼替尼治疗的mRCC患者,2例描述在晚期GIST患者中使用包括舒尼替尼在内的靶向治疗。

结果

在所有4例病例中,有效的AE管理使患者能够接受舒尼替尼长期治疗并获得持续的临床益处。2例mRCC病例显示舒尼替尼治疗反应延长且AE可控。2例GIST病例表明,包括老年患者在内的伊马替尼难治性KIT外显子9突变GIST患者对舒尼替尼可获得持续反应。

结论

这些病例研究支持舒尼替尼在治疗mRCC和伊马替尼难治性GIST方面的长期疗效和安全性,并证明了如何通过AE管理来优化患者反应。

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