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胃肠道间质瘤的当前管理:手术、当前生物标志物、突变及治疗

Current management of gastrointestinal stromal tumors: Surgery, current biomarkers, mutations, and therapy.

作者信息

Valsangkar Nakul, Sehdev Amikar, Misra Subhasis, Zimmers Teresa A, O'Neil Bert H, Koniaris Leonidas G

机构信息

Department of Surgery, Division of General Surgery, Indiana University School of Medicine, Indianapolis, IN.

Department of Medicine, Division of Hematology and Oncology, Indiana University School of Medicine, Indianapolis, IN.

出版信息

Surgery. 2015 Nov;158(5):1149-64. doi: 10.1016/j.surg.2015.06.027. Epub 2015 Aug 1.

Abstract

In the past decade, the addition of molecular diagnosis of mutations and use of tyrosine kinase inhibitors (TKIs), either as neoadjuvant/adjuvant therapy with surgery or as primary therapy in nonresectable gastrointestinal stromal tumors (GIST), has improved patient outcomes markedly. Additional therapeutics also are on the horizon. The goal of this review is to identify the current incidence, diagnostic modalities, and trends in personalizing the medical and operative management for patients with GIST. Medline, PubMed, and Google scholar were queried for recently published literature regarding new molecular mechanisms, targeted therapies, and clinical trials investigating the treatment of GIST. The objective of this review is to highlight the biomarkers under development, newly discovered mutations, and newer therapies targeting specific mutational phenotypes which are continually improving the outlook for patients with this disease.

摘要

在过去十年中,对于不可切除的胃肠道间质瘤(GIST),增加了突变的分子诊断以及使用酪氨酸激酶抑制剂(TKIs)作为手术的新辅助/辅助治疗或一线治疗,显著改善了患者的预后。其他治疗方法也即将出现。本综述的目的是确定GIST患者在个性化医疗和手术管理方面的当前发病率、诊断方式及趋势。我们检索了Medline、PubMed和谷歌学术,以查找最近发表的有关新分子机制、靶向治疗以及研究GIST治疗的临床试验的文献。本综述的目的是强调正在开发的生物标志物、新发现的突变以及针对特定突变表型的更新疗法,这些正在不断改善该疾病患者的前景。

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