Department of Sarcoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Oncology and Palliative Care, Sarcoma Center, Helios Klinikum Berlin-Buch, Berlin, Germany.
Cancer. 2021 Jul 1;127(13):2187-2195. doi: 10.1002/cncr.33630. Epub 2021 May 11.
Before the introduction of tyrosine kinase inhibitors (TKIs), the overall survival of patients with advanced or metastatic gastrointestinal stromal tumors (GISTs) was 10 to 20 months because of the lack of approved therapies. In the last 20 years, a treatment algorithm for patients with advanced GISTs, which includes imatinib, sunitinib, and regorafenib as first-, second-, and third-line therapies, respectively, has been established. Recently, 2 new TKIs have been approved: ripretinib for fourth-line therapy and avapritinib as first-line therapy in patients harboring platelet-derived growth factor receptor α (PDGFRA) exon 18 D842V mutations. Additionally, there are several experimental therapies under investigation that could advance individualized patient care. All of these therapies have varying efficacies and safety profiles that warrant an updated treatment landscape review. This review article summarizes the efficacy and safety data currently available for conventional TKIs along with recently approved and experimental therapies.
在酪氨酸激酶抑制剂 (TKI) 问世之前,由于缺乏批准的治疗方法,晚期或转移性胃肠道间质瘤 (GIST) 患者的总生存期为 10 至 20 个月。在过去的 20 年中,已经建立了一种用于晚期 GIST 患者的治疗算法,其中包括伊马替尼、舒尼替尼和瑞戈非尼分别作为一线、二线和三线治疗药物。最近,又批准了 2 种新的 TKI:四线治疗的 ripretinib 和携带血小板衍生生长因子受体 α (PDGFRA) 外显子 18 D842V 突变的患者的一线治疗药物 avapritinib。此外,还有几种正在研究的实验性治疗方法可能会推进个体化患者治疗。所有这些治疗方法的疗效和安全性特征都需要进行更新的治疗方案评估。本文综述了目前常规 TKI 以及最近批准和实验性治疗的疗效和安全性数据。