title: Successful treatment with personalized dosage of imatinib in elderly patients with gastrointestinal stromal tumors.
abstract: Imatinib is the standard first-line therapy for metastatic gastrointestinal stromal tumors. It has markedly improved the prognosis and outcome of patients affected by gastrointestinal stromal tumors, especially in the case of exon 11 KIT mutations. Imatinib-associated adverse events are generally mild to moderate; however, in clinical practice, intolerance caused by chronic toxicities frequently leads to breaks in treatment. This is particularly true in elderly patients in whom age, decline in drug metabolism, and polypharmacy, with a possible drug-drug interaction, may influence the tolerability of imatinib. In the present article, we report our extensive experience with the management of imatinib therapy in a 'real' population, in particular in very elderly patients, discussing whether the use of personalized imatinib dosage could be a safe and advantageous option, enabling continuous administration, thus ensuring effective treatment. Only a few case reports in the literature provide data on outcome with low tailored dosage of imatinib and none of them has been carried out on a Western population. Here, we report four cases treated with low imatinib dosage as a safe and useful option enabling continued treatment with imatinib, improving tolerance, and maintaining good and lasting disease control.
authors.affiliation: aDepartment of Specialized, Experimental, and Diagnostic Medicine bNuclear Medicine Unit, Department of Specialized, Experimental, and Diagnostic Medicine cCardio-thoracic Radiology Unit, Department of Specialized, Experimental, and Diagnostic Medicine dDepartment of Pathology, Laboratory of Oncologic and Transplantation Molecular Pathology ePathology Unit, Department of Specialized, Experimental, and Diagnostic Medicine, Sant'Orsola-Malpighi Hospital fInterdepartmental Centre of Cancer Research 'G. Prodi', University of Bologna, Bologna, Italy.
authors.forename: Maristella
authors.initials: M
authors.lastname: Saponara
authors.forename: Lidia
authors.initials: L
authors.lastname: Gatto
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Nunno
authors.forename: Elena
authors.initials: E
authors.lastname: Tabacchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
authors.forename: Valerio
authors.initials: V
authors.lastname: Di Scioscio
authors.forename: Margherita
authors.initials: M
authors.lastname: Nannini
authors.forename: Elisa
authors.initials: E
authors.lastname: Gruppioni
authors.forename: Annalisa
authors.initials: A
authors.lastname: Altimari
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Fiorentino
authors.forename: Donatella
authors.initials: D
authors.lastname: Santini
authors.forename: Claudio
authors.initials: C
authors.lastname: Ceccarelli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zompatori
authors.forename: Guido
authors.initials: G
authors.lastname: Biasco
authors.forename: Maria Abbondanza
authors.initials: MA
authors.lastname: Pantaleo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use*; D008297:Male; D057285:Precision Medicine; D047428:Protein Kinase Inhibitors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D000068877:Imatinib Mesylate