Predicting the antitumor effects of STI571 by analysis of c-kit gene mutations in gastrointestinal stromal tumors of the stomach: Report of a case.
We report a case of a large gastrointestinal stromal tumor (GIST), greater than 5 cm in diameter, in the stomach. Microscopically, high levels of mitosis were observed, indicative of a high-grade malignancy. We analyzed the c-kit gene mutations by a replication competent retrovirus assay and DNA sequencing, which revealed a c-kit mutation in exon 11. Liver metastases were detected 7 months after surgery. Patients with an exon 11 mutation of the c-kit gene are reported to have a high response to STI571 (imatinib mesylate, Glivec). Accordingly, a 1-month course of STI571 treatment clearly changed the characterization of the metastatic tumors radiographically. Thus, it may be important to analyze c-kit gene mutations in patients presenting with GISTs to predict the effectiveness of STI571 in suppressing GISTs, especially tumors thought to have malignant potential.
Tsuneoka
Noritsugu
N
Department of Surgery, Goto Central Hospital, 205 Yoshikugi, Goto, Nagasaki, 853-8691, Japan.
Kuroki
Tamotsu
T
Haraguchi
Masashi
M
Furui
Jyunichirou
J
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D014408:Biomarkers, Tumor / Q000235:genetics; D004273:DNA, Neoplasm / Q000187:drug effects / Q000235:genetics*; D005091:Exons; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D009154:Mutation / Q000187:drug effects*; D010879:Piperazines / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D019009:Proto-Oncogene Proteins c-kit / Q000187:drug effects / Q000235:genetics*; D011743:Pyrimidines / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology
D000970:Antineoplastic Agents; D001549:Benzamides; D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases; D019009:Proto-Oncogene Proteins c-kit