title: Alternative schedules or integration strategies to maximise treatment duration with sunitinib in patients with gastrointestinal stromal tumours.
abstract: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumour of the gastrointestinal tract. The advent of targeted kinase-inhibitors has revolutionised treatment strategies and clinical outcomes for patients with advanced GIST. In the majority of countries, sunitinib is the only approved second-line treatment option for advanced GIST patients, who are resistant or intolerant to imatinib. However, sunitinib is associated with various adverse events, which often result in a reduction of the dosage, and interruption or suspension of therapy. Effective therapy management is essential to obtain the maximum clinical benefit, and includes adequate side effect management as well as optimization of dosing and treatment duration. In the current study, examples of maximization of treatment with sunitinib are presented, describing three clinical cases in which therapy with sunitinib was continued via the adoption of alternative reduced schedules or an additional loco-regional treatment, in order to manage toxicities or overcome progressive disease.
authors.affiliation: Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy ; Interdepartmental Centre of Cancer Research 'G. Prodi', University of Bologna, Bologna 40138, Italy.
authors.forename: Maristella
authors.initials: M
authors.lastname: Saponara
authors.affiliation: Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy.
authors.forename: Cristian
authors.initials: C
authors.lastname: Lolli
authors.affiliation: Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Nannini
authors.affiliation: Department of Radiology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: DI Scioscio
authors.affiliation: Department of Digestive Disease and Internal Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Serra
authors.affiliation: Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Mandrioli
authors.affiliation: Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy.
authors.forename: Maria Caterina
authors.initials: MC
authors.lastname: Pallotti
authors.affiliation: Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy ; Interdepartmental Centre of Cancer Research 'G. Prodi', University of Bologna, Bologna 40138, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Biasco
authors.affiliation: Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy ; Interdepartmental Centre of Cancer Research 'G. Prodi', University of Bologna, Bologna 40138, Italy.
authors.forename: Maria Abbondanza
authors.initials: MA
authors.lastname: Pantaleo
keywords: alternative schedules; gastrointestinal stromal tumor; radiofrequency; sunitinib; therapy management; treatment optimization