title: [Evidence-based treatment of gastrointestinal stromal tumor (GIST) with tyrosine kinase inhibitors-imatinib and sunitinib].
abstract: Gastrointestinal stromal tumors (GIST) are sarcoma in the gastrointestinal tract which may be caused by somatic gain-of-function mutations in the KIT or PDGFRA gene. Imatinib mesylate has shown significant safety and great effectiveness for patients with KIT-positive unresectable, advanced, or metastatic GIST. The response rate (RR) was no less than 50%, disease control rate (DCR) of more than 85%, and the median progression-free survival (PFS) has been nearly two years. Also, imatinib has been shown to improve the prognosis of GIST patients. Meanwhile, sunitinib malate, used for patients with imatinib-resistant GIST or imatinib-intolerant patients, has also shown modest tolerability and fairly good outcomes. Sunitinib shows a less than 10% RR, a 30% to 40% DCR, and a median of nearly 8 months of PFS. Molecularly targeted therapy has prolonged overall survival of advanced GIST patients from 1. 5 years in the pre-imatinib era to 5 years after the introduction of imatinib. There remains, however, a great unmet medical need for new agents and/or multidisciplinary treatments for advanced GIST patients.
authors.affiliation: Dept. of Surgery, Osaka Police Hospital.
authors.forename: Toshirou
authors.initials: T
authors.lastname: Nishida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Omori
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Ueshima
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D003131:Combined Modality Therapy; D018450:Disease Progression; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D000068877:Imatinib Mesylate; D007211:Indoles / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011743:Pyrimidines / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D012008:Recurrence; D000077210:Sunitinib
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D007211:Indoles; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases; D000077210:Sunitinib