An Unusual Case of Central Retinal Vein Occlusion and Review of the Toxicity Profile of Regorafenib in GIST Patients.
Gastrointestinal stromal tumor (GIST) is the most common sarcoma of the gastrointestinal tract with around 5000 new cases per year. Outcomes for patients with GIST dramatically improved after the development of tyrosine kinase inhibitors targeted against the aberrant signaling pathways that drive GIST oncogenesis. Majority of patients derive benefit from first-line imatinib, and the type of driver mutation is predictive of response. However, almost half of the patients eventually develop resistance to initial targeted therapy and further lines of treatment do not have the same impact. Regorafenib is an oral multi-kinase inhibitor approved as a third-line therapy for advanced GIST and though its efficacy is limited in comparison to imatinib, it has activity across the various driver mutation categories in GIST even in the setting of imatinib resistance. Herein, we describe a case of central retinal vein occlusion (CRVO) secondary to regorafenib and review regorafenib's efficacy and toxicity profile.
Division of Cancer Medicine, University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, unit 463, Houston, TX, 77030, USA.
Gustavo
G
Schvartsman
Division of Cancer Medicine, University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, unit 463, Houston, TX, 77030, USA.
Michael J
MJ
Wagner
Department of Pharmacy Clinical Programs, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.
Chrystia M
CM
Zobniw
Department of Pharmacy Clinical Programs, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.
Van Anh
VA
Trinh
Department of Sarcoma Medical Oncology, University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, unit 450, Houston, TX, 77030, USA.
Shreyaskumar
S
Patel
Department of Sarcoma Medical Oncology, University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, unit 450, Houston, TX, 77030, USA. nsomaiah@mdanderson.org.
Neeta
N
Somaiah
D000368:Aged; D017809:Fatal Outcome; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000235:genetics; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000008:administration & dosage*; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage; D019009:Proto-Oncogene Proteins c-kit / Q000235:genetics; D011725:Pyridines / Q000008:administration & dosage*; D012170:Retinal Vein Occlusion / Q000139:chemically induced*
D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D011725:Pyridines; C559147:regorafenib; D000068877:Imatinib Mesylate; D019009:Proto-Oncogene Proteins c-kit
Central retinal vein occlusion; GIST; Gastrointestinal stromal tumor; KIT; Regorafenib; Tyrosine kinase inhibitors