摘要
AIM: Most gastrointestinal stromal tumors (GISTs) express constitutively activated mutant isoforms of kit kinase or platelet-derived growth factor receptor alpha (PDGFRA), which are potential therapeutic targets for imatinib mesylate (Glivec). Partial response occurred in almost two thirds of GIST patients treated with Glivec. However, complete response (CR) after Glivec therapy was sporadically reported. Here we illustrated advanced GIST patients with CR after Glivec treatment. METHODS: Between January 2001 and June 2005, 42 advanced GIST patients were treated with Glivec. Patients were administered 400 mg of Glivec in 100-mg capsules, taken orally daily with food. The response of the tumor to Glivec was evaluated after one month, three months, and every three months thereafter or whenever medical need was indicated. Each tumor of patients was investigated for mutations of kit or PDGFRA. RESULTS: The median follow-up time of the 42 ad-vanced GIST patients treated with Glivec was 16.9 months (range, 1.0- 47.0 months). Overall, 3 patients had complete response CR (7.1%), 26 partial response (67.8%), 5 stationary disease (11.9%), and 3 progressive disease (11.9%). The median duration of Glivec administration for the three patients was 36 months (range, 23-36 months). The median time to CR after Glivec treatment was 20 months (range, 9-26 months). Deletion and insertion mutations of c-kit exon 11 and insertion mutation of c-kit exon 9 were found in two cases and one case, respectively. CONCLUSION: Complete response (CR) can be achieved in selected advanced GIST patients treated with Glivec. The median time to CR after Glivec treatment was 20 months. Deletion and insertion mutations of kit exon 11 and insertion mutation of kit exon 9 contribute to the genetic features in these selected cases.
瞄准:大多数胃肠的基质肿瘤(大意) 快车组成地激活工具包激酶或导出血小板的生长因素受体高山的变异的 isoforms 哈(PDGFRA ) ,它是为 imatinib mesylate (Glivec ) 的潜在的治疗学的目标。部分反应发生在与 Glivec 对待的几乎三分之二个大意病人。然而,在 Glivec 治疗以后的完全的反应(CR ) 偶发地被报导。这里,我们在 Glivec 治疗以后与 CR 说明了先进大意病人。方法:在 2001 年 1 月和 2005 年 6 月之间, 42 个先进大意病人与 Glivec 被对待。病人们被管理在 100-mg 囊的 Glivec 的 400 mg,每天与食物口头上地拿。到 Glivec 的肿瘤的反应此后在一个月,三个月,和每三个月以后被评估或每当医药需要被显示时。病人的每个肿瘤为工具包或 PDGFRA 的变化被调查。结果:与 Glivec 对待的 42 个先进大意病人的中部的后续时间是 16.9 个月(范围, 1.0-47.0 月) 。总的来说,有的 3 个病人完成反应 CR (7.1%) , 26 部分反应(67.8%) , 5 静止疾病(11.9%) ,和 3 进步疾病(11.9%) 。为三个病人的 Glivec 管理的中部的持续时间是 36 个月(范围, 23-36 月) 。在 Glivec 治疗以后的 CR 的中部的时间是 20 个月(范围, 9-26 月) 。11 上的 c 工具包前的删除和插入变化和 9 上的 c 工具包前的插入变化分别地在二种情况和一个案例中被发现。结论:完全的反应(CR ) 能在与 Glivec 对待的选择先进大意病人被完成。在 Glivec 治疗以后的 CR 的中部的时间是 20 个月。11 上的工具包前的删除和插入变化和 9 上的工具包前的插入变化在这些选择盒子中贡献基因特征。