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

2016 ◽  
Vol 10 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Ryota Niikura ◽  
Takako Serizawa ◽  
Atsuo Yamada ◽  
Shuntaro Yoshida ◽  
Mariko Tanaka ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Imatinib Treatment ◽  
Efficacy And Safety ◽  
Tarry Stool ◽  
Dialysis Patients ◽  
Stromal Tumors ◽  
Duodenal Gist ◽  
Johnson Syndrome ◽  
Old Japanese ◽  
Steven Johnson Syndrome

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.

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

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
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.

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

2018 ◽  
Vol 104 (6) ◽  
pp. 415-422 ◽  
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.

scholarly journals Disappearing pigmentary mosaicism during imatinib treatment for gastrointestinal stromal tumors

2019 ◽  
Vol 5 (2) ◽  
pp. 170-172
Author(s):  
Emily Coleman ◽  
Gauri Panse ◽  
Shawn Cowper ◽  
Jill Lacy ◽  
Jonathan Leventhal
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Imatinib Treatment ◽  
Stromal Tumors ◽  
Pigmentary Mosaicism

Second primary malignances (SPMs) in patients with gastrointestinal stromal tumors (GIST): The potential influence of imatinib treatment.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. 10552-10552
Author(s):  
Anna Estival ◽  
Laia Espasa ◽  
Olatz Etxaniz ◽  
Ignacio Blanco ◽  
Jose Luis Cuadra-Urteaga ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Second Primary ◽  
Imatinib Treatment ◽  
Potential Influence ◽  
Stromal Tumors
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