演題抄録

パネルディスカッション

開催概要
開催回
第56回・2018年・横浜
 

イマチニブ耐性GISTに対する新規治療

演題番号 : PD20-4

[筆頭演者]
演者)内藤 陽一:1,2 

1:国立がん研究センター東病院・先端医療科、2:国立がん研究センター東病院・乳腺・腫瘍内科

 

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors arising mainly from gastrointestinal tract. Most of the GISTs harbor somatic gain-of-function aberrations in KIT, and first line standard therapy for metastatic GIST is imatinib, an oral tyrosine kinase inhibitor of KIT. Resistance to imatinib is usually classified into primary and secondary resistance. Most of primary resistance is related to the "Wild-type GIST". As the wild-type gist lacks activating KIT mutation, molecular analysis may be performed in GIST patients with primary-resistant to imatinib. Secondary resistance to imatinib is caused by KIT secondary mutations in approximately 70% of cases. Novel KIT inhibitors such as avapritinib, masitinib, and DCC-2618 are currently under investigation. Another approach to imatinib-resistant GIST is to target alternative receptor-tyrosine kinase pathway such as FGFR, IGFR, or intercellular pathway such as MEK, mTOR. Immune checkpoint inhibitors have made a success in many cancers including melanoma, lung cancer, renal cell carcinoma; however, the study for GIST has just started and the result is preliminary. In the Japanese phase II study, TAS116, an oral HSP90 inhibitor, showed promising activity and the confirmatory phase III study is warranted.

前へ戻る