Baha ZENGEL, Ahmet ALACACIOGLU, Ayse YAGCI, Hakan POSTACI, Ozgur KAVAK, Ali GALİP, Erhan GOKMEN

Inoperabl Gastrointestinal Tümörde Imatinib Mesilat Tedavisi Sonrası Patolojik Tam Yanıt: Olgu Sunumu

Gastrointestinal stromal tümörler CD34 and c-kit (CD117) ekspresyonu ile karekterize olan, gastrointestinal sistemin en sık görülen mezenkimal maligniteleridir. İmatinib mesiat, transmembran reseptör c-kit ürünlerini baskılayan küçük molekül tirozin kinaz inhibitörüdür. Metastatik ve inoperabl gastarointestinal stromal tümörlerde yapılan klinik çalışmalarda imatinib mesilat tedavisi ile parsiyel yanıt oranları 40% ile 69% arasındadır. Fakat tam yanıt nadirdir. Bu yazımızda 46 yaşında anrezektabl gastrointestinal stromal tümorlü erkek hastada, imatinib mesilat tedavisi ile sağlanan patolojik tam yanıt değerlendirilmiştir.

Anahtar Kelimeler:

Gastrointestinal stromal tümor, Imatinib mesylate, Patalojik tam yanıt, Cerrahi

Pathological Complete Response After Imatinib Mesylate Therapy in Inoperabl Gastrointestinal Stromal Tumor: A Case Report

Gastrointestinal stromal tumors are characterized by the expression of CD34 and c-kit (CD117) and represent the most common mesenchymal malignancy of the gastrointestinal tract. Imatinib mesylate is small molecule tyrosine kinase inhibitor that suppresses transmembrane receptor c-kit products. Clinical studies for metastatic and inoperabl GISTs have demonstrated partial response rate ranging from 40% to 69% in patients treated with imatinib mesylate. But complete response is rare. We present a 46 year old man patient with unresectable gastrointestinal stromal tumor that has histopatologically proven complete response to imatinib mesylate therapy.

Keywords:

-,

PDF

___

Demetri GD. Gastrointestinal stromal tumor. In: Cancer: Principles and practice of oncology, 8th ed, DeVita VT, Hellman S, Rosenberg SA (Eds), p 1257, Lippincott-Williams &Wilkins, Philadelphia, 2008.
Mazur MT, Clark HB. Gastric stromal tumors. Reappraisal of histogenesis. Am J Surg Pathol 1983; 7: 507-519.
Kindblom LG, Remotti HE, Aldenborg F, Meis-Kindblom JM. Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristic of the intersititial cell of Cajal. Am J Pathol 1998; 152: 1259-1269.
Chiang KC, Chen TW, Yeh CN, Liu FY, Lee HL, Jan YY. Advanced gastrointestinal stromal tumor patients with complete response after treatment with imatinib mesylate. World J Gastroenterol 2006; 12: 2060-2064.
Melichar B, Voboril Z, Nozicka J, et al. Pathological complete response in advanced gastrointestinal stromal tumor after imatinib therapy. Internal Medicine 2005; 44: 1163-1168.
Joensuu H, Roberts PJ, Sarlomo-Rikala M, et al. Effect of the tyrosine kinase inhibitor STI571 in a patient with a metastatic gastrointestinal stromal tumor. N Eng J Med 2001; 344: 1052- 1056.
Andtbacka RH, Ng CS, Scaife CL, et al. Surgical resection of gastrointestinal stromal tumors after treatment with imatinib. Ann Surg Oncol 2007; 14: 14-24.
Gronchi A, Fiore M, Miselli F, et al. Surgery of residual disease following molecular-targeted therapy with imatinib mesylate in advanced/metastatic GIST. Ann Surg 2007; 245: 341-346.
Nishida T, Shirao K, Sawaki A, et al. Efficacy and safety profile of imatinib mesylate (ST1571) in Japanese patients with advanced gastrointestinal stromal tumors: a phase II study (STI571B1202). Int J Clin Oncol 2008; 13: 244-251.
Goh BK, Chow PK, Chuah KL, Yap WM, Wong WK. Pathologic, radiologic and PET scan response of gastrointestinal stromal tumors after neoadjuvant treatment with imatinib mesylate. Eur J Surg Oncol 2006; 32: 961-963.
Salazar M, Barata A, André S, et al. First report of a complete pathological response of a pelvic GIST treated with imatinib as neoadjuvant therapy.Gut. 2006; 55: 585-586.
Suzuki S, Sasajima K, Miyamoto M, et al. Pathologic complete response confirmed by surgical resection for liver metastases of gastrointestinal stromal tumor after treatment with imatinib mesylate. World J Gastroenterol 2008; 14: 3763- 3767.
Gönderilme Tarihi: 01.12.2010