[A case of recurrent duodenal gastrointestinal stromal tumor resistant to imatinib and sunitinib, successfully treated with regorafenib]

Gan To Kagaku Ryoho. 2014 Nov;41(12):1545-7.
[Article in Japanese]

Abstract

Regorafenib is a novel, orally administered multi-kinase inhibitor that has recently been approved for the treatment of recurrent gastrointestinal stromal tumor (GIST). We report a case of successful treatment of recurrent duodenal GIST, which was found to be resistant to imatinib and sunitinib, with regorafenib. A 62-year-old woman underwent a pancreatoduodenectomy for duodenal GIST; after 2 years, a computed tomography (CT) scan detected liver metastases. The patient received imatinib for 6 years, and underwent 2 hepatectomies. Subsequently, she received sunitinib for 10 months; however, CT scans revealed the presence of multiple vertebral metastases. She underwent a laminectomy for the palliative treatment of the vertebral metastases. Upon immunohistochemical examination, the recurrent tumor stained positive for c-kit, confirming the diagnosis for GIST. Consequently, the patient received regorafenib; although the treatment controlled the liver metastases, the vertebral metastases were found to have progressed. She survived for 9 years and 5 months after the initial surgical resection. Regorafenib might be beneficial in the treatment of recurrent GISTs that prove to be resistant to imatinib and sunitinib.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Benzamides / administration & dosage
  • Drug Resistance, Neoplasm*
  • Duodenal Neoplasms / drug therapy*
  • Duodenal Neoplasms / pathology
  • Duodenal Neoplasms / surgery
  • Fatal Outcome
  • Female
  • Gastrointestinal Stromal Tumors / drug therapy*
  • Gastrointestinal Stromal Tumors / surgery
  • Hepatectomy
  • Humans
  • Imatinib Mesylate
  • Indoles / administration & dosage
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery
  • Middle Aged
  • Phenylurea Compounds / therapeutic use*
  • Piperazines / administration & dosage
  • Pyridines / therapeutic use*
  • Pyrimidines / administration & dosage
  • Pyrroles / administration & dosage
  • Recurrence
  • Sunitinib
  • Treatment Outcome

Substances

  • Benzamides
  • Indoles
  • Phenylurea Compounds
  • Piperazines
  • Pyridines
  • Pyrimidines
  • Pyrroles
  • regorafenib
  • Imatinib Mesylate
  • Sunitinib