演題抄録

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開催概要
開催回
第56回・2018年・横浜
 

イマチニブ耐性GISTに対する分子標的治療を中心とした集学的治療の成績

演題番号 : PD20-3

[筆頭演者]
演者)高橋 剛:1 
[共同演者]
斉藤 百合奈:1、高 正浩:1、石田 智:1、田中 晃司:1、宮崎 安弘:1、牧野 知紀:1、黒川 幸典:1、中島 清一:1、山崎 誠:1、森 正樹:1、土岐 祐一郎:1

1:大阪大学・消化器外科

 

[Background] The standard first-line treatment for unresectable or recurrent GIST is imatinib mesylate. Although imatinib has markedly improved the prognosis of patients with advanced GIST, approximately half of the patients experience tumor progression within two years because of resistance. Imatinib-resistant GIST is treated using other kind of TKI and surgery. [Aim]We aimed to clarify the outcome of the multimodal therapy mainly on the molecular target treatment for the unresectable and/or recurrent GIST. [Material and methods] We retrospectively collected the data on 60 unresectable or recurrent GIST patients who had imatinib therapy between 2003 and 2018. [Results] There are 36 male and 24 female patients, and the age was 62 (26-86) years. The origin was stomach (24), small intestine (30), and large intestine (6) respectively. All patients were treated imatinib at first, and the median progression free survival (PFS) was 26 months. We treated surgical intervention for 19 patients diagnosed as focal imatinib resistance and continuation of imatinib and median PFS was 22 months. We treated other kinds of TKIs, sunitinib (55 patients) and regorafenib (17 patients) therapy for generalized imatinib resistance. The median PFS was 6(1-26) months, 7.8(0.5-28) months respectively. At the initiation of each molecular target medicine, patients are supervised by the pharmacist and received several kinds of preventive agents for side-effects. And, although dose modifications due to toxicities were very common, almost all patients were treated safely. The overall survival rates were 91% (3years) and 71% (5years) after initiation of imatinib therapy. [Conclusions] he multimodal therapy mainly on the molecular target might improve the prognosis of the unresectable and/or recurrent GIST.

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