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The use of regorafenib in patients with disseminated gastrointestinal stromal tumours. A review of the literature. A clinical case

https://doi.org/10.21518/2079-701X-2018-10-12-16

Abstract

The survival of patients even with disseminated disease reached 7–8 years after introduction of imatinib and sunitinib for the treatment of gastrointestinal stromal tumours (GIST) into everyday clinical practice. These drugs efficacy is largely determined by the presence and any mutations of C-KIT and PDGFR genes. It was established that new mutations appear in most tumours against the background of tyrosine kinase inhibitors therapy, which causes the development of secondary resistance and the progression of the disease in most cases. The search for opportunities to overcome the newly developed or initially existing resistance caused by different gene mutations continues to be of vital importance. One of such drugs is regorafenib, which has demonstrated antitumour activity against progression on imatinib and/or sunitinib. The paper reviews the studies of the efficacy of regoraphanib in patients with disseminated GIST, taking into account the presence and any mutations of C-KIT and PDGFR genes, and presents a description of their own clinical case of prolonged use of the drug in a patient who have received earlier both imatinib and sunitinib.

About the Authors

D. A. Filonenko
N.N.Blokhin Russian Cancer Research Centre, Federal State Budgetary Institution of the Ministry of Health of Russia
Russian Federation
Moscow


S. V. Petukhova
Clinical Hospital of the Administrative Department of the President of the Russian Federation, Federal State Budgetary Institution
Russian Federation
Moscow


E. I. Khatkova
Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of Russia
Russian Federation
Moscow


K. A. Vorontsova
N.N.Blokhin Russian Cancer Research Centre, Federal State Budgetary Institution of the Ministry of Health of Russia
Russian Federation
Moscow


E. I. Chichikov
N.N.Blokhin Russian Cancer Research Centre, Federal State Budgetary Institution of the Ministry of Health of Russia
Russian Federation
Moscow


B. M. Medvedeva
N.N.Blokhin Russian Cancer Research Centre, Federal State Budgetary Institution of the Ministry of Health of Russia
Russian Federation
Moscow


L. G. Zhukova
N.N.Blokhin Russian Cancer Research Centre, Federal State Budgetary Institution of the Ministry of Health of Russia
Russian Federation
Moscow


References

1. George S, Wang Q, Heinrich MC, Corless CL, Zhu M et.al. Efficacy and safety of regorafenib in patients with metastatic and/or unresectable GI stromal tumor after failure of imatinib and sunitinib: a multicenter phase II trial. J Clin Oncol, 2012, 30(19): 2401. Epub 2012 May 21.

2. Ben-Ami E, Barysauskas CM, von Mehren M, Heinrich MC, Corless CL et al. Long-term follow-up results of the multicenter phase II trial of regorafenib in patients with metastatic and/or unresectable GI stromal tumor after failure of standard tyrosine kinase inhibitor therapy. Ann Oncol, 2016 Sep, 27(9): 1794-9. Epub 2016 Jul 1.

3. Demetri GD, Reichardt P, Kang YK, Blay JY, Rutkowski P et al GRID study investigators. Efficacy and safety of regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib (GRID): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet, 2013, 381(9863): 295. Epub 2012 Nov 22.

4. Chun-Nan Yeh, Ming-Huang Chen, Yen-Yang Chen, Ching-Yao Yang, ChuehChuan Yen, et al. A phase II trial of regorafenib in patients with metastatic and/or a unresectable gastrointestinal stromal tumor harboring secondary mutations of exon 17. Oncotarget, 2017, 8(27): 44121-44130.

5. Grellety T, Kind M, Coindre J-M. Clinical activity of regorafenib in PDGFRA-mutated gastrointestinal stromal tumor. Future Sci OA, 2015 Nov 1, 1(4): FSO33. doi: 10.4155/fso.15.33. eCollection 2015 Nov.

6. A randomised trial of Imatinib alternating with Regorafenib compared to Imatinib alone for the first line treatment of advanced gastrointestinal stromal tumor (GIST) (ALT GIST) ClinicalTrials.gov Identifier: NCT02365441.

7. Phase Ib study of sunitinib alternating with regorafenib in patients with metastatic and/or unresectable GIST (SURE) ClinicalTrials.gov Identifier: NCT02164240.

8. Phase II study of Regorafenib continuous dosing of regorafenib in patients with GISTs. ClinicalTrials.gov Identifier: NCT02889328.

9. Phase II Study of Regorafenib Continuous Dosing of Regorafenib in Patients With GISTs. ID Number: AMC1602. NCT Identifier: NCT02889328

10. Single Agent Regorafenib in First-line for Metastatic/Unresectable KIT/PDGFR Wild Type GIST (REGISTRI). ClinicalTrials.gov Identifier: NCT02638766.


Review

For citations:


Filonenko DA, Petukhova SV, Khatkova EI, Vorontsova KA, Chichikov EI, Medvedeva BM, Zhukova LG. The use of regorafenib in patients with disseminated gastrointestinal stromal tumours. A review of the literature. A clinical case. Meditsinskiy sovet = Medical Council. 2018;(10):12-16. (In Russ.) https://doi.org/10.21518/2079-701X-2018-10-12-16

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ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)