关键词: 胃肠间质瘤, 伊马替尼耐药, 舒尼替尼, 瑞格非尼, 减瘤手术

Abstract:

Management strategies for advanced gastrointestinal stromal tumors after failure of imatinib        SU Xiang-qian, YANG Hong. Department of Minimally Invasive Gastrointestinal Surgery，Beijing Cancer Hospital & Institute, Peking University Cancer Hospital，Peking University School of Oncology，Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education)，Beijing 100142，China
Corresponding author: SU Xiang-qian，E-mail: suxiangqian@bjmu.edu.cn
Abstract    Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. Imatinib is presently the standard first-line therapy for patients with metastatic or unresectable GIST. As entering the clinical arena in the last decade, imatinib substantially improved the outcome in the formerly untreatable carcinomas. However, most advanced GIST responding to imatinib will progress within 2-3 years due to heterogeneous subclones harboring a range of imatinib-resistant secondary c-kit mutations. Sunitinib and more recently regorafenib, have obtained US Food and Drug Administration approval for the treatment of GIST after imatinib failure, and thus expanded the treatment options in resistant disease. Patients with metastatic GIST who have focal resistance to tyrosine kinase inhibitor therapy may bene?t from surgical cytoreduction. Furthermore, surgery may also provide palliation in certain patients with advanced disease who experience intestinal obstruction, perforation or hemorrhage.

Key words: gastrointestinal stromal tumors, imatinib-resistant, sunitinib, regorafenib, cytoreduction