a Fellow (PGY5), Department of Hematology Oncology , Fox Chase Cancer Center , Philadelphia , PA , USA.
b Director of Sarcoma Oncology, Associate Director for Clinical Research , Fox Chase Cancer Center , Philadelphia , PA , USA.
Expert Opin Emerg Drugs. 2017 Dec;22(4):317-329. doi: 10.1080/14728214.2017.1411479. Epub 2017 Dec 18.
Tyrosine kinase inhibitors (TKIs) have transformed the treatment landscape for patients with gastrointestinal stromal tumors (GIST). Unfortunately, resistance to the currently approved TKIs poses a huge challenge, and patients are in need of additional therapeutic options. Fortunately, many novel therapeutic approaches are being tested in treatment of GIST to overcome resistance to the approved TKIs Areas covered: We performed an extensive literature (PUBMED) search to identify emerging drugs being tested in treatment of GIST in early phase clinical trials. We discuss recent ongoing research and emerging novel inhibitors of KIT and PDGFRA receptors, inhibitors in downstream signaling pathways (mTOR and PIK3 inhibitors), inhibitors of other potential targets including ETV1/MEK, MET, FGFR, IGF1R, histone deacetylase inhibitors, heat shock protein 90 inhibitors, cyclin-dependent kinase inhibitors and immune checkpoint inhibitors in treatment of GIST Expert opinion: Multiple agents are under evaluation; those that benefit GIST patients with imatinib resistant mutations, or those with benefit in patients refractory to approved agents are most likely to be developed in this disease. The role of immunotherapy for GIST is still investigational.
酪氨酸激酶抑制剂 (TKIs) 改变了胃肠道间质瘤 (GIST) 患者的治疗格局。不幸的是,目前批准的 TKI 耐药性带来了巨大的挑战,患者需要更多的治疗选择。幸运的是,许多新的治疗方法正在 GIST 的治疗中进行测试,以克服对批准的 TKI 的耐药性。
我们进行了广泛的文献(PUBMED)检索,以确定正在早期临床试验中测试用于治疗 GIST 的新兴药物。我们讨论了最近正在进行的研究和新兴的 KIT 和 PDGFRA 受体抑制剂、下游信号通路(mTOR 和 PIK3 抑制剂)抑制剂、其他潜在靶点的抑制剂,包括 ETV1/MEK、MET、FGFR、IGF1R、组蛋白去乙酰化酶抑制剂、热休克蛋白 90 抑制剂、细胞周期蛋白依赖性激酶抑制剂和免疫检查点抑制剂在 GIST 的治疗中的应用。
正在评估多种药物;那些对伊马替尼耐药突变的 GIST 患者有益的药物,或对批准药物耐药的患者有益的药物,最有可能在这种疾病中得到开发。免疫疗法在 GIST 中的作用仍在研究中。