伊马替尼治疗晚期胃肠道间质瘤

背景与目的:胃肠道间质瘤(gastrointestinal stromal tumors,GISTs)是胃肠道最常见的间叶源性肿瘤,对传统的化疗耐药.本研究评价选择性的酪氨酸激酶抑制剂伊马替尼治疗晚期胃肠道间质瘤的效果.方法:入组60例患者,男性43例,女性17例,95.0%的患者体能状况评分(ECOG)0～2分.中位年龄53岁(23～80岁).所有患者口服伊马替尼400 mg/d,评价抗肿瘤疗效和安全性,主要的入选标准是晚期胃肠道间质瘤,有可测量病灶.结果:1例无法评价疗效,无CR,PR 35例(59.3%,35/59),SD持续6个月以上者13例(22.0%,13/59),6个月内PD 11例(18.6%,11/59).不良反应较轻,最常见的Ⅲ～Ⅳ度毒性有出血(6.7%,4/60)、贫血 (5.0%,3/60)、水肿(3.3%,2/60)、腹痛 (3.3%,2/60)、腹泻 (3.3%,2/60)和恶心(3.3%,2/60).结论:酪氨酸激酶抑制剂伊马替尼治疗晚期胃肠道间质瘤有一定疗效,且毒性可耐受.

Imatinib in patients with advanced gastrointestinal stromal tumours (GISTs)

Background and purpose:GISTs are the most common form of mesenchymal tumor in gastrointestinal tract.GISTs show high-level primary resistance to conventional chemotherapy.This study evaluated the efficacy of the selective tyrosine kinase inhibitor imatinib in the treatment of patients with advanced GISTs.Methods:Sixty patients with measurable advanced GISTs were enrolled into the study and received 400 mg of imatinib daily.Immediate response,safety and tolerability of the drug were observed.Results:Sixty patients with the Eastern Cooperative Oncology Group PS 0-2(95%)were treated,43 of them were men and 17 were women.The median age was 53 years(range,23-80).Tumor response could not be evaluated in 1 patient.No patient had complete response to the treatment.35(59.3%)have been confirmed as partial response,13(22.0%)had stable disease for more than six months,and 11(18.6%)had progressive disease within six months.The adverse events were mostly mild.The grade 3/4 toxicities were mainly haemorrhage(6.7%),anemia(5.0%),edema(3.3%),abdominal pain(3.3%),diarrhea(3.3%)and nausea(3.3%).Conclusions:Most patients with advanced GISTs achieved clinical benefit and had encouraging immediate responses with imatinib.The treatment was well tolerated.