Safety of Regular-Dose Imatinib Therapy in Patients with Gastrointestinal Stromal Tumors Undergoing Dialysis

The number of cancer patients undergoing dialysis has been increasing, and the number of these patients on chemotherapy is also increasing. Imatinib is an effective and safe therapy for KIT-positive gastrointestinal stromal tumors (GIST), but the efficacy and safety of imatinib in dialysis patients remain unclear. Because clinical trials have not been conducted in this population, more investigations are required. We report on a 75-year-old Japanese man undergoing dialysis who presented with massive tarry stool from a duodenal GIST. The duodenal GIST was 14 cm in diameter with multiple liver and bone metastases. The patient underwent an urgent pancreaticoduodenectomy to achieve hemostasis. After surgery, he was administered imatinib 400 mg/day. No severe adverse event including myelosuppression, congestive heart failure, liver functional impairment, intestinal pneumonia, or Steven-Johnson syndrome occurred, and the liver metastasis remained stable for 4 months. During chemotherapy, hemodialysis continued three times per week without adverse events. We suggest that regular-dose imatinib is an effective and safe treatment in patients with GIST undergoing dialysis. In addition, we present a literature review of the effectiveness and safety of imatinib treatment in dialysis patients.

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Decrease of CD117 expression as possible prognostic marker for recurrence in the resected specimen after imatinib treatment in patients with initially unresectable gastrointestinal stromal tumors: a clinicopathological analysis

Anti-Cancer Drugs ◽

10.1097/cad.0b013e32830138f9 ◽

2008 ◽

Vol 19 (6) ◽

pp. 607-612 ◽

Cited By ~ 11

Author(s):

Amir Mearadji ◽

Michael A. den Bakker ◽

Albertus N. van Geel ◽

Alexander M.M. Eggermont ◽

Stefan Sleijfer ◽

...

Keyword(s):

Prognostic Marker ◽

Gastrointestinal Stromal Tumors ◽

Resected Specimen ◽

Imatinib Treatment ◽

Stromal Tumors ◽

Clinicopathological Analysis

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Correction: The Therapeutic Response of Gastrointestinal Stromal Tumors to Imatinib Treatment Assessed by Intravoxel Incoherent Motion Diffusion-Weighted Magnetic Resonance Imaging with Histopathological Correlation

PLoS ONE ◽

10.1371/journal.pone.0174192 ◽

2017 ◽

Vol 12 (3) ◽

pp. e0174192 ◽

Cited By ~ 1

Author(s):

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Gastrointestinal Stromal Tumors ◽

Therapeutic Response ◽

Intravoxel Incoherent Motion ◽

Imatinib Treatment ◽

Resonance Imaging ◽

Stromal Tumors ◽

Histopathological Correlation ◽

Weighted Magnetic Resonance Imaging

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Endoscopic Removal of Gastrointestinal Stromal Tumors in the Stomach: A Single-Center Experience

Gastroenterology Research and Practice ◽

10.1155/2019/3087298 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Yingjie Guo ◽

Xue Jing ◽

Jian Zhang ◽

Xueli Ding ◽

Xiaoyu Li ◽

...

Keyword(s):

Tumor Size ◽

Gastrointestinal Stromal Tumors ◽

Average Length ◽

Risk Classification ◽

Low Risk ◽

Efficacy And Safety ◽

Endoscopic Removal ◽

Moderate Risk ◽

Stromal Tumors ◽

Gastric Gists

Background and Aims. Endoscopic removal of GISTs (gastrointestinal stromal tumors) is recently recognized, but less is known about its efficacy and safety. This study is aimed at assessing the feasibility, clinical efficacy, and safety of the endoscopic removal of gastric GISTs. Patients and Methods. Endoscopic removal (ER) of GISTs was performed in 134 patients at our hospital between January 2015 and January 2019. The clinical features, surgical outcomes, complications, pathological diagnosis, and risk classification were evaluated retrospectively. Results. ER was successful in 131 cases (98%), including 58 by ESD (endoscopic submucosal dissection), 43 by ESE (endoscopic submucosal excavation), 25 by EFTR (endoscopic full-thickness resection), and 5 by STER (submucosal tunneling endoscopic resection). In addition, GISTs of two cases were resected using LECS (laparoscopic and luminal endoscopic cooperative surgery) for the extraluminal and intraluminal growth pattern. The average tumor size was 1.89±1.25 cm (range: 0.5-6.0 cm). Of these patients, 26 cases had a large tumor size (range: 2.0-6.0 cm), and endoscopic removal was successful in all of them. During the procedure, endoclips were used to close the perforation in all cases, without conversion to open surgery. The average length of hospital stay was 5.50±2.15 days (range: 3-10 days). In the risk classification, 106 (79.7%) were of a very low risk, 25 (18.8%) of a low risk, and 2 (1.5%) of a moderate risk. The moderate-risk cases were treated with imatinib mesylate after ER. No recurrence or metastasis was observed during the follow-up period of 23±8 months (range: 3-48 months). Conclusions. The endoscopic treatment is feasible, effective, and safe for gastric GISTs, and individualized choice of approaches is recommended for GISTs.

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Effect of the imatinib treatment regimen on the postoperative prognosis of patients with high-risk gastrointestinal stromal tumors

OncoTargets and Therapy ◽

10.2147/ott.s198129 ◽

2019 ◽

Vol Volume 12 ◽

pp. 4713-4719 ◽

Cited By ~ 1

Author(s):

Yan-Shu Li ◽

Wei Li ◽

Qing-Sheng Zeng ◽

Wei-Hua Fu

Keyword(s):

High Risk ◽

Treatment Regimen ◽

Gastrointestinal Stromal Tumors ◽

Imatinib Treatment ◽

Postoperative Prognosis ◽

Stromal Tumors

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Blood neutrophil-to-lymphocyte ratio is associated with prognosis in advanced gastrointestinal stromal tumors treated with imatinib

Tumori Journal ◽

10.1177/0300891618765543 ◽

2018 ◽

Vol 104 (6) ◽

pp. 415-422 ◽

Cited By ~ 2

Author(s):

Piotr Rutkowski ◽

Paweł Teterycz ◽

Anna Klimczak ◽

Elżbieta Bylina ◽

Katarzyna Szamotulska ◽

...

Keyword(s):

Disease Progression ◽

Gastrointestinal Stromal Tumors ◽

Proportional Hazards Model ◽

Cox Proportional Hazards Model ◽

Neutrophil To Lymphocyte Ratio ◽

Rank Test ◽

Imatinib Treatment ◽

Stromal Tumors ◽

Lymphocyte Ratio ◽

Advanced Gist

Introduction: Neutrophil-to-lymphocyte ratio (NLR) was shown to be prognostic in several solid malignancies. There are limited data about predictive/prognostic value of NLR during targeted therapy of patients with advanced gastrointestinal stromal tumors (GIST). The aim of this study was to asses a clinical value of this ratio in patients with advanced GIST. Methods: Between 2001 and 2016, 385 patients with metastatic/unresectable GIST treated initially with imatinib were included in the analysis. In all patients, the NLR was assessed at the baseline, after 3 months of treatment, and upon disease progression (or last observation). The cutoff values for NLR were set at 2.7 and 5.4. Kaplan-Meier survival probability estimation with log-rank test and Cox proportional hazards model were used for analysis. Results: Median progression-free survival (PFS) on imatinib treatment was 44.8 months, 5-year rate 43%; median overall survival (OS) 87.2 months, 10-year rate 36.3%. NLR >2.7 at baseline was significantly associated with poorer OS and PFS: median OS was 89.3 months (95% confidence interval [CI] 80.2-115) for NLR ratio ≤2.7 vs 59.4 months (95% CI 48.6-82) for NLR >2.7 ( p < .001); median PFS was 59.4 vs 32.7 ( p < .001), respectively. In multivariate model adjusted for mitotic index and driver mutation in the tumor ( KIT exon 11 mutation versus other), NLR ratio was proven to be statistically significant (hazard ratio 1.09; 95% CI 1.01-1.19; p = .030). Among patients with disease progression, NLR >2.7 assessed at the third month of treatment was linked with significantly shorter median time to progression (7.5 vs 19 months). Conclusions: Our results demonstrate the usefulness of NLR as a prognostic and predictive marker as well as a marker for treatment monitoring in patients with advanced GIST treated with imatinib.

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