Response to Nilotinib as a First-Line Treatment for Metastatic Gastrointestinal Stromal Tumors

Purpose Effective and safe treatment options are needed for patients with advanced gastrointestinal stromal tumors (GIST) who are initially unresponsive to the tyrosine kinase inhibitor (TKI) imatinib, or develop acquired secondary imatinib resistance. Case Report We report a 39-year-old woman with...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Schlemmer, Marcus [verfasserIn] Schinwald, Nicole [verfasserIn] Bruns, Christiane [verfasserIn] Berger, Frank [verfasserIn] Reichardt, Peter [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2010

Schlagwörter:	GIST Imatinib Nilotinib TKI

Übergeordnetes Werk:	Enthalten in: International journal of gastrointestinal cancer - Totowa, NJ : Humana Press, 1986, 43(2010), 2 vom: 05. Okt., Seite 385-387
Übergeordnetes Werk:	volume:43 ; year:2010 ; number:2 ; day:05 ; month:10 ; pages:385-387

Links:	Volltext

DOI / URN:	10.1007/s12029-010-9208-2

Katalog-ID:	SPR023823623

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520			\|a Purpose Effective and safe treatment options are needed for patients with advanced gastrointestinal stromal tumors (GIST) who are initially unresponsive to the tyrosine kinase inhibitor (TKI) imatinib, or develop acquired secondary imatinib resistance. Case Report We report a 39-year-old woman with primary rectal GIST who underwent abdominoperineal resection in December 2004, achieving R0 margins. In August 2009, the patient was referred to our clinic, and we detected metastatic GIST of the liver, as well as peritoneal and gluteal lesions. The patient was treated with imatinib 400 mg/day for 3 weeks and subsequently switched to nilotinib (400 mg bid) after enrolling in a clinical trial. After 8 weeks of nilotinib treatment, a response was observed in the liver metastasis, and metabolic activity was no longer detected. Also, the gluteal and peritoneal lesions were no longer detected. After 16 weeks of nilotinib treatment, a cystic mass was identified in the liver metastasis. Tumor rupture was considered a strong possibility, prompting resection of the liver metastasis. Greater than 80% of the resected tumor mass was necrotic, consistent with the lack of metabolism observed 8 weeks prior. The patient resumed nilotinib treatment (400 mg bid) shortly after surgery and continues treatment while remaining disease-free for more than 9 months with normal liver function. Conclusion This is the first report demonstrating the feasibility of nilotinib (400 mg bid) for the first-line treatment of metastatic GIST. Furthermore, these results underscore that responses to TKIs may be underestimated by Response Evaluation Criteria in Solid Tumors.
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allfields	10.1007/s12029-010-9208-2 doi (DE-627)SPR023823623 (SPR)s12029-010-9208-2-e DE-627 ger DE-627 rakwb eng 610 ASE Schlemmer, Marcus verfasserin aut Response to Nilotinib as a First-Line Treatment for Metastatic Gastrointestinal Stromal Tumors 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose Effective and safe treatment options are needed for patients with advanced gastrointestinal stromal tumors (GIST) who are initially unresponsive to the tyrosine kinase inhibitor (TKI) imatinib, or develop acquired secondary imatinib resistance. Case Report We report a 39-year-old woman with primary rectal GIST who underwent abdominoperineal resection in December 2004, achieving R0 margins. In August 2009, the patient was referred to our clinic, and we detected metastatic GIST of the liver, as well as peritoneal and gluteal lesions. The patient was treated with imatinib 400 mg/day for 3 weeks and subsequently switched to nilotinib (400 mg bid) after enrolling in a clinical trial. After 8 weeks of nilotinib treatment, a response was observed in the liver metastasis, and metabolic activity was no longer detected. Also, the gluteal and peritoneal lesions were no longer detected. After 16 weeks of nilotinib treatment, a cystic mass was identified in the liver metastasis. Tumor rupture was considered a strong possibility, prompting resection of the liver metastasis. Greater than 80% of the resected tumor mass was necrotic, consistent with the lack of metabolism observed 8 weeks prior. The patient resumed nilotinib treatment (400 mg bid) shortly after surgery and continues treatment while remaining disease-free for more than 9 months with normal liver function. Conclusion This is the first report demonstrating the feasibility of nilotinib (400 mg bid) for the first-line treatment of metastatic GIST. Furthermore, these results underscore that responses to TKIs may be underestimated by Response Evaluation Criteria in Solid Tumors. GIST (dpeaa)DE-He213 Imatinib (dpeaa)DE-He213 Nilotinib (dpeaa)DE-He213 TKI (dpeaa)DE-He213 Schinwald, Nicole verfasserin aut Bruns, Christiane verfasserin aut Berger, Frank verfasserin aut Reichardt, Peter verfasserin aut Enthalten in International journal of gastrointestinal cancer Totowa, NJ : Humana Press, 1986 43(2010), 2 vom: 05. Okt., Seite 385-387 (DE-627)363738215 (DE-600)2103370-5 1559-0739 nnns volume:43 year:2010 number:2 day:05 month:10 pages:385-387 https://dx.doi.org/10.1007/s12029-010-9208-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 43 2010 2 05 10 385-387
spelling	10.1007/s12029-010-9208-2 doi (DE-627)SPR023823623 (SPR)s12029-010-9208-2-e DE-627 ger DE-627 rakwb eng 610 ASE Schlemmer, Marcus verfasserin aut Response to Nilotinib as a First-Line Treatment for Metastatic Gastrointestinal Stromal Tumors 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose Effective and safe treatment options are needed for patients with advanced gastrointestinal stromal tumors (GIST) who are initially unresponsive to the tyrosine kinase inhibitor (TKI) imatinib, or develop acquired secondary imatinib resistance. Case Report We report a 39-year-old woman with primary rectal GIST who underwent abdominoperineal resection in December 2004, achieving R0 margins. In August 2009, the patient was referred to our clinic, and we detected metastatic GIST of the liver, as well as peritoneal and gluteal lesions. The patient was treated with imatinib 400 mg/day for 3 weeks and subsequently switched to nilotinib (400 mg bid) after enrolling in a clinical trial. After 8 weeks of nilotinib treatment, a response was observed in the liver metastasis, and metabolic activity was no longer detected. Also, the gluteal and peritoneal lesions were no longer detected. After 16 weeks of nilotinib treatment, a cystic mass was identified in the liver metastasis. Tumor rupture was considered a strong possibility, prompting resection of the liver metastasis. Greater than 80% of the resected tumor mass was necrotic, consistent with the lack of metabolism observed 8 weeks prior. The patient resumed nilotinib treatment (400 mg bid) shortly after surgery and continues treatment while remaining disease-free for more than 9 months with normal liver function. Conclusion This is the first report demonstrating the feasibility of nilotinib (400 mg bid) for the first-line treatment of metastatic GIST. Furthermore, these results underscore that responses to TKIs may be underestimated by Response Evaluation Criteria in Solid Tumors. GIST (dpeaa)DE-He213 Imatinib (dpeaa)DE-He213 Nilotinib (dpeaa)DE-He213 TKI (dpeaa)DE-He213 Schinwald, Nicole verfasserin aut Bruns, Christiane verfasserin aut Berger, Frank verfasserin aut Reichardt, Peter verfasserin aut Enthalten in International journal of gastrointestinal cancer Totowa, NJ : Humana Press, 1986 43(2010), 2 vom: 05. Okt., Seite 385-387 (DE-627)363738215 (DE-600)2103370-5 1559-0739 nnns volume:43 year:2010 number:2 day:05 month:10 pages:385-387 https://dx.doi.org/10.1007/s12029-010-9208-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 43 2010 2 05 10 385-387
allfields_unstemmed	10.1007/s12029-010-9208-2 doi (DE-627)SPR023823623 (SPR)s12029-010-9208-2-e DE-627 ger DE-627 rakwb eng 610 ASE Schlemmer, Marcus verfasserin aut Response to Nilotinib as a First-Line Treatment for Metastatic Gastrointestinal Stromal Tumors 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose Effective and safe treatment options are needed for patients with advanced gastrointestinal stromal tumors (GIST) who are initially unresponsive to the tyrosine kinase inhibitor (TKI) imatinib, or develop acquired secondary imatinib resistance. Case Report We report a 39-year-old woman with primary rectal GIST who underwent abdominoperineal resection in December 2004, achieving R0 margins. In August 2009, the patient was referred to our clinic, and we detected metastatic GIST of the liver, as well as peritoneal and gluteal lesions. The patient was treated with imatinib 400 mg/day for 3 weeks and subsequently switched to nilotinib (400 mg bid) after enrolling in a clinical trial. After 8 weeks of nilotinib treatment, a response was observed in the liver metastasis, and metabolic activity was no longer detected. Also, the gluteal and peritoneal lesions were no longer detected. After 16 weeks of nilotinib treatment, a cystic mass was identified in the liver metastasis. Tumor rupture was considered a strong possibility, prompting resection of the liver metastasis. Greater than 80% of the resected tumor mass was necrotic, consistent with the lack of metabolism observed 8 weeks prior. The patient resumed nilotinib treatment (400 mg bid) shortly after surgery and continues treatment while remaining disease-free for more than 9 months with normal liver function. Conclusion This is the first report demonstrating the feasibility of nilotinib (400 mg bid) for the first-line treatment of metastatic GIST. Furthermore, these results underscore that responses to TKIs may be underestimated by Response Evaluation Criteria in Solid Tumors. GIST (dpeaa)DE-He213 Imatinib (dpeaa)DE-He213 Nilotinib (dpeaa)DE-He213 TKI (dpeaa)DE-He213 Schinwald, Nicole verfasserin aut Bruns, Christiane verfasserin aut Berger, Frank verfasserin aut Reichardt, Peter verfasserin aut Enthalten in International journal of gastrointestinal cancer Totowa, NJ : Humana Press, 1986 43(2010), 2 vom: 05. Okt., Seite 385-387 (DE-627)363738215 (DE-600)2103370-5 1559-0739 nnns volume:43 year:2010 number:2 day:05 month:10 pages:385-387 https://dx.doi.org/10.1007/s12029-010-9208-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 43 2010 2 05 10 385-387
allfieldsGer	10.1007/s12029-010-9208-2 doi (DE-627)SPR023823623 (SPR)s12029-010-9208-2-e DE-627 ger DE-627 rakwb eng 610 ASE Schlemmer, Marcus verfasserin aut Response to Nilotinib as a First-Line Treatment for Metastatic Gastrointestinal Stromal Tumors 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose Effective and safe treatment options are needed for patients with advanced gastrointestinal stromal tumors (GIST) who are initially unresponsive to the tyrosine kinase inhibitor (TKI) imatinib, or develop acquired secondary imatinib resistance. Case Report We report a 39-year-old woman with primary rectal GIST who underwent abdominoperineal resection in December 2004, achieving R0 margins. In August 2009, the patient was referred to our clinic, and we detected metastatic GIST of the liver, as well as peritoneal and gluteal lesions. The patient was treated with imatinib 400 mg/day for 3 weeks and subsequently switched to nilotinib (400 mg bid) after enrolling in a clinical trial. After 8 weeks of nilotinib treatment, a response was observed in the liver metastasis, and metabolic activity was no longer detected. Also, the gluteal and peritoneal lesions were no longer detected. After 16 weeks of nilotinib treatment, a cystic mass was identified in the liver metastasis. Tumor rupture was considered a strong possibility, prompting resection of the liver metastasis. Greater than 80% of the resected tumor mass was necrotic, consistent with the lack of metabolism observed 8 weeks prior. The patient resumed nilotinib treatment (400 mg bid) shortly after surgery and continues treatment while remaining disease-free for more than 9 months with normal liver function. Conclusion This is the first report demonstrating the feasibility of nilotinib (400 mg bid) for the first-line treatment of metastatic GIST. Furthermore, these results underscore that responses to TKIs may be underestimated by Response Evaluation Criteria in Solid Tumors. GIST (dpeaa)DE-He213 Imatinib (dpeaa)DE-He213 Nilotinib (dpeaa)DE-He213 TKI (dpeaa)DE-He213 Schinwald, Nicole verfasserin aut Bruns, Christiane verfasserin aut Berger, Frank verfasserin aut Reichardt, Peter verfasserin aut Enthalten in International journal of gastrointestinal cancer Totowa, NJ : Humana Press, 1986 43(2010), 2 vom: 05. Okt., Seite 385-387 (DE-627)363738215 (DE-600)2103370-5 1559-0739 nnns volume:43 year:2010 number:2 day:05 month:10 pages:385-387 https://dx.doi.org/10.1007/s12029-010-9208-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 43 2010 2 05 10 385-387
allfieldsSound	10.1007/s12029-010-9208-2 doi (DE-627)SPR023823623 (SPR)s12029-010-9208-2-e DE-627 ger DE-627 rakwb eng 610 ASE Schlemmer, Marcus verfasserin aut Response to Nilotinib as a First-Line Treatment for Metastatic Gastrointestinal Stromal Tumors 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose Effective and safe treatment options are needed for patients with advanced gastrointestinal stromal tumors (GIST) who are initially unresponsive to the tyrosine kinase inhibitor (TKI) imatinib, or develop acquired secondary imatinib resistance. Case Report We report a 39-year-old woman with primary rectal GIST who underwent abdominoperineal resection in December 2004, achieving R0 margins. In August 2009, the patient was referred to our clinic, and we detected metastatic GIST of the liver, as well as peritoneal and gluteal lesions. The patient was treated with imatinib 400 mg/day for 3 weeks and subsequently switched to nilotinib (400 mg bid) after enrolling in a clinical trial. After 8 weeks of nilotinib treatment, a response was observed in the liver metastasis, and metabolic activity was no longer detected. Also, the gluteal and peritoneal lesions were no longer detected. After 16 weeks of nilotinib treatment, a cystic mass was identified in the liver metastasis. Tumor rupture was considered a strong possibility, prompting resection of the liver metastasis. Greater than 80% of the resected tumor mass was necrotic, consistent with the lack of metabolism observed 8 weeks prior. The patient resumed nilotinib treatment (400 mg bid) shortly after surgery and continues treatment while remaining disease-free for more than 9 months with normal liver function. Conclusion This is the first report demonstrating the feasibility of nilotinib (400 mg bid) for the first-line treatment of metastatic GIST. Furthermore, these results underscore that responses to TKIs may be underestimated by Response Evaluation Criteria in Solid Tumors. GIST (dpeaa)DE-He213 Imatinib (dpeaa)DE-He213 Nilotinib (dpeaa)DE-He213 TKI (dpeaa)DE-He213 Schinwald, Nicole verfasserin aut Bruns, Christiane verfasserin aut Berger, Frank verfasserin aut Reichardt, Peter verfasserin aut Enthalten in International journal of gastrointestinal cancer Totowa, NJ : Humana Press, 1986 43(2010), 2 vom: 05. Okt., Seite 385-387 (DE-627)363738215 (DE-600)2103370-5 1559-0739 nnns volume:43 year:2010 number:2 day:05 month:10 pages:385-387 https://dx.doi.org/10.1007/s12029-010-9208-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 43 2010 2 05 10 385-387
language	English
source	Enthalten in International journal of gastrointestinal cancer 43(2010), 2 vom: 05. Okt., Seite 385-387 volume:43 year:2010 number:2 day:05 month:10 pages:385-387
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Case Report We report a 39-year-old woman with primary rectal GIST who underwent abdominoperineal resection in December 2004, achieving R0 margins. In August 2009, the patient was referred to our clinic, and we detected metastatic GIST of the liver, as well as peritoneal and gluteal lesions. The patient was treated with imatinib 400 mg/day for 3 weeks and subsequently switched to nilotinib (400 mg bid) after enrolling in a clinical trial. After 8 weeks of nilotinib treatment, a response was observed in the liver metastasis, and metabolic activity was no longer detected. Also, the gluteal and peritoneal lesions were no longer detected. After 16 weeks of nilotinib treatment, a cystic mass was identified in the liver metastasis. Tumor rupture was considered a strong possibility, prompting resection of the liver metastasis. Greater than 80% of the resected tumor mass was necrotic, consistent with the lack of metabolism observed 8 weeks prior. The patient resumed nilotinib treatment (400 mg bid) shortly after surgery and continues treatment while remaining disease-free for more than 9 months with normal liver function. Conclusion This is the first report demonstrating the feasibility of nilotinib (400 mg bid) for the first-line treatment of metastatic GIST. 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author	Schlemmer, Marcus
spellingShingle	Schlemmer, Marcus ddc 610 misc GIST misc Imatinib misc Nilotinib misc TKI Response to Nilotinib as a First-Line Treatment for Metastatic Gastrointestinal Stromal Tumors
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topic_title	610 ASE Response to Nilotinib as a First-Line Treatment for Metastatic Gastrointestinal Stromal Tumors GIST (dpeaa)DE-He213 Imatinib (dpeaa)DE-He213 Nilotinib (dpeaa)DE-He213 TKI (dpeaa)DE-He213
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title	Response to Nilotinib as a First-Line Treatment for Metastatic Gastrointestinal Stromal Tumors
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title_full	Response to Nilotinib as a First-Line Treatment for Metastatic Gastrointestinal Stromal Tumors
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title_sort	response to nilotinib as a first-line treatment for metastatic gastrointestinal stromal tumors
title_auth	Response to Nilotinib as a First-Line Treatment for Metastatic Gastrointestinal Stromal Tumors
abstract	Purpose Effective and safe treatment options are needed for patients with advanced gastrointestinal stromal tumors (GIST) who are initially unresponsive to the tyrosine kinase inhibitor (TKI) imatinib, or develop acquired secondary imatinib resistance. Case Report We report a 39-year-old woman with primary rectal GIST who underwent abdominoperineal resection in December 2004, achieving R0 margins. In August 2009, the patient was referred to our clinic, and we detected metastatic GIST of the liver, as well as peritoneal and gluteal lesions. The patient was treated with imatinib 400 mg/day for 3 weeks and subsequently switched to nilotinib (400 mg bid) after enrolling in a clinical trial. After 8 weeks of nilotinib treatment, a response was observed in the liver metastasis, and metabolic activity was no longer detected. Also, the gluteal and peritoneal lesions were no longer detected. After 16 weeks of nilotinib treatment, a cystic mass was identified in the liver metastasis. Tumor rupture was considered a strong possibility, prompting resection of the liver metastasis. Greater than 80% of the resected tumor mass was necrotic, consistent with the lack of metabolism observed 8 weeks prior. The patient resumed nilotinib treatment (400 mg bid) shortly after surgery and continues treatment while remaining disease-free for more than 9 months with normal liver function. Conclusion This is the first report demonstrating the feasibility of nilotinib (400 mg bid) for the first-line treatment of metastatic GIST. Furthermore, these results underscore that responses to TKIs may be underestimated by Response Evaluation Criteria in Solid Tumors.
abstractGer	Purpose Effective and safe treatment options are needed for patients with advanced gastrointestinal stromal tumors (GIST) who are initially unresponsive to the tyrosine kinase inhibitor (TKI) imatinib, or develop acquired secondary imatinib resistance. Case Report We report a 39-year-old woman with primary rectal GIST who underwent abdominoperineal resection in December 2004, achieving R0 margins. In August 2009, the patient was referred to our clinic, and we detected metastatic GIST of the liver, as well as peritoneal and gluteal lesions. The patient was treated with imatinib 400 mg/day for 3 weeks and subsequently switched to nilotinib (400 mg bid) after enrolling in a clinical trial. After 8 weeks of nilotinib treatment, a response was observed in the liver metastasis, and metabolic activity was no longer detected. Also, the gluteal and peritoneal lesions were no longer detected. After 16 weeks of nilotinib treatment, a cystic mass was identified in the liver metastasis. Tumor rupture was considered a strong possibility, prompting resection of the liver metastasis. Greater than 80% of the resected tumor mass was necrotic, consistent with the lack of metabolism observed 8 weeks prior. The patient resumed nilotinib treatment (400 mg bid) shortly after surgery and continues treatment while remaining disease-free for more than 9 months with normal liver function. Conclusion This is the first report demonstrating the feasibility of nilotinib (400 mg bid) for the first-line treatment of metastatic GIST. Furthermore, these results underscore that responses to TKIs may be underestimated by Response Evaluation Criteria in Solid Tumors.
abstract_unstemmed	Purpose Effective and safe treatment options are needed for patients with advanced gastrointestinal stromal tumors (GIST) who are initially unresponsive to the tyrosine kinase inhibitor (TKI) imatinib, or develop acquired secondary imatinib resistance. Case Report We report a 39-year-old woman with primary rectal GIST who underwent abdominoperineal resection in December 2004, achieving R0 margins. In August 2009, the patient was referred to our clinic, and we detected metastatic GIST of the liver, as well as peritoneal and gluteal lesions. The patient was treated with imatinib 400 mg/day for 3 weeks and subsequently switched to nilotinib (400 mg bid) after enrolling in a clinical trial. After 8 weeks of nilotinib treatment, a response was observed in the liver metastasis, and metabolic activity was no longer detected. Also, the gluteal and peritoneal lesions were no longer detected. After 16 weeks of nilotinib treatment, a cystic mass was identified in the liver metastasis. Tumor rupture was considered a strong possibility, prompting resection of the liver metastasis. Greater than 80% of the resected tumor mass was necrotic, consistent with the lack of metabolism observed 8 weeks prior. The patient resumed nilotinib treatment (400 mg bid) shortly after surgery and continues treatment while remaining disease-free for more than 9 months with normal liver function. Conclusion This is the first report demonstrating the feasibility of nilotinib (400 mg bid) for the first-line treatment of metastatic GIST. Furthermore, these results underscore that responses to TKIs may be underestimated by Response Evaluation Criteria in Solid Tumors.
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