[A case of recurrent duodenal gastrointestinal stromal tumor resistant to imatinib and sunitinib, successfully treated with regorafenib].
Regorafenib is a novel, orally administered multi-kinase inhibitor that has recently been approved for the treatment of recurrent gastrointestinal stromal tumor (GIST). We report a case of successful treatment of recurrent duodenal GIST, which was found to be resistant to imatinib and sunitinib, with regorafenib. A 62-year-old woman underwent a pancreatoduodenectomy for duodenal GIST; after 2 years, a computed tomography (CT) scan detected liver metastases. The patient received imatinib for 6 years, and underwent 2 hepatectomies. Subsequently, she received sunitinib for 10 months; however, CT scans revealed the presence of multiple vertebral metastases. She underwent a laminectomy for the palliative treatment of the vertebral metastases. Upon immunohistochemical examination, the recurrent tumor stained positive for c-kit, confirming the diagnosis for GIST. Consequently, the patient received regorafenib; although the treatment controlled the liver metastases, the vertebral metastases were found to have progressed. She survived for 9 years and 5 months after the initial surgical resection. Regorafenib might be beneficial in the treatment of recurrent GISTs that prove to be resistant to imatinib and sunitinib.
Dept. of Surgery, Kansai Rosai Hospital.
Yutaka
Y
Takeda
Shin
S
Nakahira
Yoshiteru
Y
Katsura
Yoshiaki
Y
Ohmura
Hiroki
H
Kusama
Yusuke
Y
Kuroda
Takayoshi
T
Goto
Tadayoshi
T
Hashimoto
Kei
K
Kimura
Katsunori
K
Matsushita
Yasufumi
Y
Sato
Yoshihiro
Y
Morimoto
Tomo
T
Ishida
Kanae
K
Nitta
Yoshinori
Y
Kagawa
Masatsugu
M
Okishiro
Atsushi
A
Takeno
Hideki
H
Sakisaka
Hirokazu
H
Taniguchi
Chiyomi
C
Egawa
Kenji
K
Ohzono
Shinichi
S
Nakatsuka
Takeshi
T
Kato
Shigeyuki
S
Tamura
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001549:Benzamides / Q000008:administration & dosage; D019008:Drug Resistance, Neoplasm; D004379:Duodenal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000601:surgery; D006498:Hepatectomy; D006801:Humans; D000068877:Imatinib Mesylate; D007211:Indoles / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D010879:Piperazines / Q000008:administration & dosage; D011725:Pyridines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000008:administration & dosage; D011758:Pyrroles / Q000008:administration & dosage; D012008:Recurrence; D000077210:Sunitinib; D016896:Treatment Outcome
D001549:Benzamides; D007211:Indoles; D010671:Phenylurea Compounds; D010879:Piperazines; D011725:Pyridines; D011743:Pyrimidines; D011758:Pyrroles; C559147:regorafenib; D000068877:Imatinib Mesylate; D000077210:Sunitinib