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Medical treatment of localized and advanced GIST: therapeutic standards in 2006 |
Bulletin du Cancer. Volume 93, Number 4, 173-80, Numéro hors-série, Avril 2006, Synthèse
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 Résumé
Article gratuit
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Author(s) : Jérôme Fayette, Pierre Méeus, Isabelle Ray-Coquard, Dominique Ranchère, Philippe Thiesse, Anne-Valérie Decouvelaere, Marie-Pierre Sunyach, François Mithieux, Séverine Tabone-Eglinger, Sylvie Bonvalot, Jean-Yves Scoazec, Pierre Paul Bringuier, Jean-Michel Coindre, Binh Bui, Axel Le Cesne, Jean-Yves Blay |
Summary : GIST are the most frequent sarcomas of the digestive tract. Patients with advanced GIST had a very poor prognosis before the introduction of imatinib, a targeted oncogene therapy which inhibits the function of the activated KIT and PDGFRα oncogene. The standard treatment of the localised GIST is surgery, and adjuvant treatment remains experimental. Conversely, in patients with locally advanced or metastatic disease, the standard first line treatment is imatinib at the dose of 400 mg/d continued until progression. Secondary resistances appear and the median progression free survival under imatinib is 24 months. These secondary resistances are related in 50% of the cases to the appearance of secondary changes in the genes KIT or PDGFRα. In the event of progression under imatinib, it will be necessary to increase the dose to 800 mg/d which brings a benefit in a significant number of cases. After failure of high dose of imatinib, novel tyrosine kinase inhibitors are under development. |
Keywords : sarcoma, GIST, imatinib, tyrosine-kinase inhibitors |
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