Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 02-781, Warsaw, Poland.
Drugs Aging. 2021 May;38(5):375-396. doi: 10.1007/s40266-021-00841-x. Epub 2021 Mar 2.
Gastrointestinal stromal tumors (GIST) originating in the Cajal cells are the most common mesenchymal neoplasms of the gastrointestinal tract. The median age of patients with this diagnosis is 65 years, and over 20% of cases affect people over the age of 70 years. The effectiveness and tolerability of systemic treatment with tyrosine kinase inhibitors in older patients with GIST seem to be similar to that in younger patients, but some studies have shown that treatment of older patients is suboptimal. Disability, frailty, comorbidities, and concomitant medications may influence treatment decisions, and toxicities also more often lead to treatment discontinuation. The known safety profile and oral administration route of the tyrosine kinase inhibitors used in GIST may allow maximization of treatment and the best efficacy, especially in older patients. This review summarizes the efficacy data for the systemic treatment of GIST, including data for older patients and from real-world experiences, if available and significant. The reported safety data and general rules for toxicity management, including appropriate patient selection and the need for careful monitoring during treatment, are also discussed.
胃肠道间质瘤（GIST）起源于 Cajal 细胞，是胃肠道最常见的间叶性肿瘤。该诊断的中位年龄为 65 岁，超过 20%的病例发生在 70 岁以上的人群中。对于老年 GIST 患者，使用酪氨酸激酶抑制剂进行系统治疗的有效性和耐受性似乎与年轻患者相似，但一些研究表明，老年患者的治疗效果并不理想。残疾、虚弱、合并症和伴随用药可能会影响治疗决策，毒性也更常导致治疗中断。GIST 中使用的酪氨酸激酶抑制剂已知的安全性和口服给药途径可能允许最大限度地治疗和最佳疗效，尤其是在老年患者中。这篇综述总结了 GIST 系统治疗的疗效数据，包括老年患者和真实世界经验的数据（如果有的话）。还讨论了报告的安全性数据和毒性管理的一般规则，包括适当的患者选择和治疗期间需要仔细监测。
