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雑誌文献

臨床外科67巻11号

2012年10月発行

文献概要

特集 外科医のための癌診療データ 臓器別最新データ 10.消化管間質腫瘍(GIST)

GISTの非切除・再発例

著者: 尾上琢磨1 土井俊彦2

所属機関: 1兵庫県立がんセンター腫瘍内科 2国立がん研究センター東病院消化管内科

ページ範囲:P.281 - P.289

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覚えておきたいデータ

◆切除不能なGISTに対する初回化学療法の第一選択薬はイマチニブであり,400mg/日を可能な限り継続することが推奨される.

◆イマチニブ耐性となったGISTにはスニチニブ投与が推奨される.多様な有害事象があるため,細やかなマネージメントが重要である.

◆新規マルチキナーゼ阻害剤の第Ⅲ相試験の結果が報告された.今後,イマチニブ,スニチニブ治療終了後の新たな治療戦略として期待される.

参考文献

1)日本癌治療学会/日本胃癌学会/GIST研究会(編):GIST診療ガイドライン2010年11月改訂(第2版補訂版).金原出版,2010
2)Choi H, Charnsangavej C, Faria SC, et al:Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate:proposal of new computed tomography response criteria. J Clin Oncol 25:1753-1759, 2007
3)Demetri GD, von Mehren M, Blanke CD, et al:Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 347:472-480, 2002
4)Verweij J, Casali PG, Zalcberg J, et al:Progression-free survival in gastrointestinal stromal tumours with high-dose imatinib:randomised trial. Lancet 364:1127-1134, 2004
5)Blanke CD, Rankin C, Demetri GD, et al:Phase Ⅲ randomized, intergroup trial assessing imatinib mesylate at two dose levels in patients with unresectable or metastatic gastrointestinal stromal tumors expressing the kit receptor tyrosine kinase:S0033. J Clin Oncol 26:626-632, 2008
6)Blay JY, Le Cesne A, Ray-Coquard I, et al:Prospective multicentric randomized phase Ⅲ study of imatinib in patients with advanced gastrointestinal stromal tumors comparing interruption versus continuation of treatment beyond 1 year:The French Sarcoma Group. J Clin Oncol 25:1107-1113, 2007
7)Le Cesne A, Ray-Coquard I, Bui BN, et al:Discontinuation of imatinib in patients with advanced gastrointestinal stromal tumours after 3 years of treatment:an open-label multicentre randomised phase 3 trial. Lancet Oncol 11:942-949, 2010
8)Ray-Conquard IL, Bui BN, Adenis A, et al:Risk of relapse with imatinib(IM)discontinuation at 5 years in advanced GIST patients:Results of the prospective BFR14 randomized phase Ⅲ study comparing interruption versus continuation of IM at 5 years of treatment:A French Sarcoma Group Study. 2010 ASCO Annual Meeting Abstract, No:10032
9)Heinrich MC, Corless CL, Demetri GD, et al:Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. J Clin Oncol 21:4342-4349, 2003
10)Zalcberg JR, Verweij J, Casali PG, et al:Outcome of patients with advanced gastro-intestinal stromal tumours crossing over to a daily imatinib dose of 800mg after progression on 400mg. Eur J Cancer 41:1751-1757, 2005
11)Demetri GD, van Oosterom AT, Garrett CR, et al:Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib:a randomised controlled trial. Lancet 368:1329-1338, 2006
12)George S, Lechner T, Li S, et al:Hypertension(HTN)as a potential biomarker of efficacy in patients(pts)with gastrointestinal stromal tumor(GIST)treated with sunitinib(SU). 2011 ASCO Gastrointestinal Cancers Symposium Abstract No:38
13)Blay JY:New paradigms in gastrointestinal stromal tumor management. Ann Oncol 20(Suppl 1):i18-i24 2009
14)Sawaki A, Kanda T, Komatsu Y:Impact of imatinib plus best supportive care in imatinib- and sunitinib-exposed patients with refractory advanced gastrointestinal stromal tumor. 2010 ASCO Annual Meeting Abstract, No:10064
15)NCCN Clinical Practice Guidelines in Oncology Soft Tissue Sarcoma ver. 1. 2012
16)DeMatteo RP, Lewis JJ, Leung D, et al:Two hundred gastrointestinal stromal tumors. recurrence patterns and prognostic factors for survival. Ann Surg 231:51-58, 2000
17)ノバルティスファーマ株式会社ホームページ(http://www.novartis.co.jp)およびグリベック添付文書
18)ファイザー株式会社ホームページ(http://www.pfizer.co.jp)およびスーテントカプセル適正使用ガイド
19)Demetri GD, Reichardt P, Yoon-Koo K, et al:Randomized phase Ⅲ trial of regorafenib in patients(pts)with metastatic and/or unresectable gastrointestinal stromal tumor(GIST)progressing despite prior treatment with at least imatinib(IM)and sunitinib(SU):GRID trial. 2012 ASCO Annual Meeting Abstract, No:LBA10008
20)Adenis A, Le Cesne A, Nguyen BB, et al:Masitinib mesylate in imatinib-resistant advanced GIST:A randomized phase Ⅱ trial. 2012 ASCO Annual Meeting Abstract, No:10007

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1278

印刷版ISSN:0386-9857

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