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Surgery Today
Erschienen in: Surgery Today 6/2019

15.11.2018 | Review Article

Neoadjuvant imatinib therapy in rectal gastrointestinal stromal tumors

verfasst von: Manabu Kaneko, Shigenobu Emoto, Koji Murono, Hirofumi Sonoda, Masaya Hiyoshi, Kazuhito Sasaki, Yasutaka Shuno, Takeshi Nishikawa, Toshiaki Tanaka, Keisuke Hata, Kazushige Kawai, Hiroaki Nozawa

Erschienen in: Surgery Today | Ausgabe 6/2019

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Abstract

Rectal gastrointestinal stromal tumor (GIST) is a rare entity. Thus, its clinical features have not been well documented, and optimal treatment strategies have not been established. Surgery for rectal GISTs may be difficult because they are often large in size. In addition, rectal GISTs were found to be associated with high rates of local recurrence, regardless of the surgical procedure, before imatinib was introduced in the early 2000s. Since the introduction of imatinib therapy, accumulating evidence suggests that neoadjuvant imatinib therapy may improve the outcomes of rectal GIST treatment. Neoadjuvant imatinib therapy for rectal GISTs offers a number of potential benefits, including tumor downsizing, reduction in mitotic activity, reduced morbidity, and a reduced risk of recurrence. Less radical procedures may allow for the preservation of the anal sphincter and avoidance of a permanent colostomy. This review summarizes the current status and future perspectives of neoadjuvant imatinib therapy for the treatment of rectal GISTs.
Literatur
1.
Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumors: recent advances in understanding of their biology. Hum Pathol. 1999;30:1213–20.CrossRefPubMed
2.
Tran T, Davila JA, El-Serag HB. The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000. Am J Gastroenterol. 2005;100:162–8.CrossRefPubMed
3.
Tielen R, Verhoef C, van Coevorden F, Reyners AK, van der Graaf WT, Bonenkamp JJ, et al. Surgical management of rectal gastrointestinal stromal tumors. J Surg Oncol. 2013;107:320–3.CrossRefPubMed
4.
Changchien CR, Wu MC, Tasi WS, Tang R, Chiang JM, Chen JS, et al. Evaluation of prognosis for malignant rectal gastrointestinal stromal tumor by clinical parameters and immunohistochemical staining. Dis Colon Rectum. 2004;47:1922–9.CrossRefPubMed
5.
Miettinen M, Furlong M, Sarlomo-Rikala M, Burke A, Sobin LH, Lasota J. Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the rectum and anus: a clinicopathologic, immunohistochemical, and molecular genetic study of 144 cases. Am J Surg Pathol. 2001;25:1121–33.CrossRefPubMed
6.
Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70–83.CrossRefPubMed
7.
DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231:51–8.CrossRefPubMedPubMedCentral
8.
Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol. 2008;39:1411–9.CrossRefPubMed
9.
Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol. 2002;33:459–65.CrossRefPubMed
10.
Jakob J, Mussi C, Ronellenfitsch U, Wardelmann E, Negri T, Gronchi A, et al. Gastrointestinal stromal tumor of the rectum: results of surgical and multimodality therapy in the era of imatinib. Ann Surg Oncol. 2013;20:586–92.CrossRefPubMed
11.
Wilkinson MJ, Fitzgerald JE, Strauss DC, Hayes AJ, Thomas JM, Messiou C, et al. Surgical treatment of gastrointestinal stromal tumour of the rectum in the era of imatinib. Br J Surg. 2015;102:965–71.CrossRefPubMed
12.
Pai VD, Demenezes JL, Patil PS, Saklani AP. Multimodality therapy of rectal gastrointestinal stromal tumors in the era of imatinib-an indian series. J Gastrointest Oncol. 2016;7:262–8.PubMedPubMedCentral
13.
Cavnar MJ, Wang L, Balachandran VP, Antonescu CR, Tap WD, Keohan M, et al. Rectal gastrointestinal stromal tumor (GSIT) in the era of imatinib: organ preservation and improved oncologic outcome. Ann Surg Oncol. 2017;24:3972–80.CrossRefPubMedPubMedCentral
14.
Joensuu H, Roberts PJ, Sarlomo-Rikala M, Andersson LC, Tervahartiala P, Tuveson D, et al. Effect of the tyrosine kinase inhibitor STI571 in a patient with a metastatic gastrointestinal stromal tumor. N Engl J Med. 2001;344:1052–6.CrossRefPubMed
15.
Demetri GD, von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med. 2002;347:472–80.CrossRefPubMed
16.
van Oosterom AT, Judson IR, Verweij J, Stroobants S, Dumez H, Donato di Paola E, et al. Update of phase i study of imatinib (STI571) in advanced soft tissue sarcomas and gastrointestinal stromal tumors: a report of the EORTC soft tissue and bone sarcoma group. Eur J Cancer. 2002;38:83–7.CrossRef
17.
Verweij J, Casali PG, Zalcberg J, LeCesne A, Reichardt P, Blay JY, et al. Progression-free survival in gastrointestinal stromal tumours with high-dose imatinib: randomised trial. Lancet. 2004;364:1127–34.CrossRefPubMed
18.
Verweij J, van Oosterom A, Blay JY, Judson I, Rodenhuis S, van der Graaf W, et al. Imatinib mesylate (STI-571 Glivec, Gleevec) is an active agent for gastrointestinal stromal tumours, but does not yield responses in other soft-tissue sarcomas that are unselected for a molecular target. Results from an EORTC soft tissue and bone sarcoma group phase II study. Eur J Cancer. 2003;39:2006–11.CrossRefPubMed
19.
Lo SS, Papachristou GI, Finkelstein SD, Conroy WP, Schraut WH, Ramanathan RK. Neoadjuvant imatinib in gastrointestinal stromal tumor of the rectum: report of a case. Dis Colon Rectum. 2005;48:1316–19.CrossRefPubMed
20.
Fiore M, Palassini E, Fumagalli E, Pilotti S, Tamborini E, Stacchiotti S, et al. Preoperative imatinib mesylate for unresectable or locally advanced primary gastrointestinal stromal tumors (GIST). Eur J Surg Oncol. 2009;35:739–45.CrossRefPubMed
21.
Eisenberg BL, Harris J, Blanke CD, Demetri GD, Heinrich MC, Watson JC, et al. Phase II trial of neoadjuvant/adjuvant imatinib mesylate (IM) for advanced primary and metastatic/recurrent operable gastrointestinal stromal tumor (GIST): early results of RTOG 0132/ACRIN 6665. J Surg Oncol. 2009;99:42–7.CrossRefPubMedPubMedCentral
22.
Mandala M, Pezzica E, Tamborini E, Guerra U, Lagonigro SM, Forloni B, et al. Neoadjuvant imatinib in a locally advanced gastrointestinal stromal tumour (GIST) of the rectum: a rare case of two GISTs within a family without a familial GIST syndrome. Eur J Gastroenterol Hepatol. 2007;19:711–3.CrossRefPubMed
23.
Ebihara Y, Okushiba S, Kawarada Y, Kitashiro S, Katoh H, Kondo S. Neoadjuvant imatinib in a gastrointestinal stromal tumor of the rectum: report of a case. Surg Today. 2008;38:174–7.CrossRefPubMed
24.
Fujimoto Y, Akiyoshi T, Konishi T, Nagayama S, Fukunaga Y, Ueno M. Laparoscopic sphincter-preserving surgery (intersphincteric resection) after neoadjuvant imatinib treatment for gastrointestinal stromal tumor (GIST) of the rectum. Int J Colorectal Dis. 2014;29:111–6.CrossRefPubMed
25.
Nozawa H, Kanazawa T, Tanaka T, Takahashi M, Ishihara S, Sunami E, et al. Laparoscopic resection of a gastrointestinal stromal tumor of the lower rectum in a patient with coronary artery disease following long-term neoadjuvant imatinib treatment and anticoagulation therapy. World J Surg Oncol. 2014;12:211.CrossRefPubMedPubMedCentral
26.
Ueki T, Nagayoshi K, Manabe T, Maeyama R, Yokomizo A, Yamamoto H, et al. Laparoscopic en bloc excision of gastrointestinal stromal tumors of the rectum after neoadjuvant imatinib therapy: anteriorly extended intersphincteric resection combined with partial resection of the prostate. Tech Coloproctol. 2015;19:247–51.CrossRefPubMed
27.
Nahas CS, Nahas SC, Marques CF, Schmerling R, Bustamante-Lopez LA, Ribeiro U, et al. Gastrointestinal stromal tumor of the rectum treated with neoadjuvant Imatinib followed by transanal endoscopic microsurgery. Arq Bras Cir Dig. 2015;28:87–9.CrossRefPubMedPubMedCentral
28.
Kyo K, Azuma M, Okamoto K, Nishiyama M, Shimamura T, Maema A, et al. Neoadjuvant imatinib treatment and laparoscopic anus-preserving surgery for a large gastrointestinal stromal tumor of the rectum. World J Surg Oncol. 2016;14:68.CrossRefPubMedPubMedCentral
29.
Kaneko M, Nozawa H, Emoto S, Murono K, Sasaki K, Otani K, et al. Neoadjuvant imatinib therapy followed by intersphincteric resection for low rectal gastrointestinal stromal tumors. Anticancer Res. 2017;37:5155–60.CrossRefPubMed
30.
Machlenkin S, Pinsk I, Tulchinsky H, Ziv Y, Sayfan J, Duek D, et al. The effect of neoadjuvant imatinib therapy on outcome and survival after rectal gastrointestinal stromal tumour. Colorectal Dis. 2011;13:1110–5.CrossRefPubMed
31.
Wang JP, Wang T, Huang MJ, Wang L, Kang L, Wu XJ. The role of neoadjuvant imatinib mesylate therapy in sphincter-preserving procedures for anorectal gastrointestinal stromal tumor. Am J Clin Oncol. 2011;34:314–6.CrossRefPubMed
32.
Sun LF, He JJ, Yu SJ, Xu JH, Wang JW, Li J, et al. Transsacral excision with pre-operative imatinib mesylate treatment and approach for gastrointestinal stromal tumors in the rectum: a report of two cases. Oncol Lett. 2014;8:1455–60.CrossRefPubMedPubMedCentral
33.
Nakamura T, Mitomi H, Onozato W, Sato T, Ikeda A, Naito M, et al. Laparoscopic resection of a gastrointestinal stromal tumor of the rectum after treatment with imatinib mesylate: report of a case. Surg Today. 2012;42:1096–9.CrossRefPubMed
34.
Huynh TK, Meeus P, Cassier P, Bouche O, Lardiere-Deguelte S, Adenis A, et al. Primary localized rectal/pararectal gastrointestinal stromal tumors: results of surgical and multimodal therapy from the French sarcoma group. BMC Cancer. 2014;14:156.CrossRefPubMedPubMedCentral
35.
Liu H, Yan Z, Liao G, Yin H. Treatment strategy of rectal gastrointestinal stromal tumor (GIST). J Surg Oncol. 2014;109:708–13.CrossRefPubMed
36.
Wachter N, Worns MA, Dos Santos DP, Lang H, Huber T, Kneist W. Transanal minimally invasive surgery (TAMIS) approach for large juxta-anal gastrointestinal stromal tumour. J Minim Access Surg. 2016;12:289–91.CrossRefPubMedPubMedCentral
37.
Hou Y-Y, Zhou Y, Lu SH, Qi WD, Xu C, Hou J, et al. Imatinib mesylate neoadjuvant treatment for rectal malignant gastrointestinal stromal tumor. World J Gastroenterol. 2009;15:1910–3.CrossRefPubMedPubMedCentral
38.
Hohenberger P, Eisenberg B. Role of surgery combined with kinase inhibition in the management of gastrointestinal stromal tumor (GIST). Ann Surg Oncol. 2010;17:2585–600.CrossRefPubMed
39.
Casali PG, Jost L, Reichardt P, Schlemmer M, Blay JY. Gastrointestinal stromal tumors: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2008;19:35–8.
40.
41.
Bonvalot S, Eldweny H, Péchoux CL, Vanel D, Terrier P, Cavalcanti A, et al. Impact of surgery on advanced gastrointestinal stromal tumors (GIST) in the imatinib era. Ann Surg Oncol. 2006;13:1596–603.CrossRefPubMed
42.
Rutkowski P, Gronchi A, Hohenberger P, Bonvalot S, Schoffski P, Bauer S, et al. Neoadjuvant imatinib in locally advanced gastrointestinal stromal tumors (GIST): the EORTC STBSG experience. Ann Surg Oncol. 2013;20:2937–43.CrossRefPubMed
43.
Kurokawa Y, Yang HK, Cho H, Ryu MH, Masuzawa T, Park SR, et al. Phase II study of neoadjuvant imatinib in large gastrointestinal stromal tumours of the stomach. Br J Cancer. 2017;117:25–32.CrossRefPubMedPubMedCentral
44.
McAuliffe JC, Hunt KK, Lazar AJ, Choi H, Qiao W, Thall P, et al. A randomized, phase II study of preoperative plus postoperative imatinib in GIST: Evidence of rapid radiographic response and temporal induction of tumor cell apoptosis. Ann Surg Oncol. 2009;16:910–9.CrossRefPubMed
45.
Corless CL, Antonescu CR, Kolesnikova V, Maki RG, Pisters PW, Blackstein ME, et al. Pathologic and molecular features correlate with long-term outcome after adjuvant therapy of resected primary GI stromal tumor: the ACOSOG Z9001 trial. J Clin Oncol. 2014;32:1563–70.CrossRefPubMedPubMedCentral
46.
Heinrich MC, Corless CL, Demetri GD, Blanke CD, von Mehren M, Joensuu H, et al. Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. J Clin Oncol. 2003;21:4342–9.CrossRefPubMed
47.
Medeiros F, Corless CL, Duensing A, Hornick JL, Oliveira AM, Heinrich MC, et al. KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications. Am J Surg Pathol. 2004;28:889–94.CrossRefPubMed
48.
Debiec-Rychter M, Dumez H, Judson I, Wasag B, Verweij J, Brown M, et al. Use of c-KIT/PDGFRA mutational analysis to predict the clinical response to imatinib in patients with advanced gastrointestinal stromal tumours entered on phase I and II studies of the EORTC soft tissue and bone sarcoma group. Eur J Cancer. 2004;40:689–95.CrossRefPubMed
49.
Debiec-Rychter M, Sciot R, Le Cesne A, Schlemmer M, Hohenberger P, van Oosterom AT, et al. KIT mutations and dose selection for imatinib in patients with advanced gastrointestinal stromal tumours. Eur J Cancer. 2006;42:1093–103.CrossRefPubMed
50.
Heinrich MC, Owzar K, Corless CL, Hollis D, Borden EC, Fletcher CD, et al. Correlation of kinase genotype and clinical outcome in the north American intergroup phase III trial of imatinib mesylate for treatment of advanced gastrointestinal stromal tumor: CALGB 150105 study by cancer and leukemia group B and southwest oncology group. J Clin Oncol. 2008;26:5360–7.CrossRefPubMedPubMedCentral
51.
Joensuu H, DeMatteo RP. The management of gastrointestinal stromal tumors: a model for targeted and multidisciplinary therapy of malignancy. Ann Rev Med. 2012;63:247–58.CrossRefPubMed
52.
Gastrointestinal Stromal Tumor Meta-Analysis Group (MetaGIST). Comparison of two doses of imatinib for the treatment of unresectable or metastatic gastrointestinal stromal tumors: a meta-analysis of 1,640 patients. J Clin Oncol. 2010;28:1247–53.CrossRef
53.
Pidhorecky I, Cheney RT, Kraybill WG, Gibbs JF. Gastrointestinal stromal tumors: current diagnosis, biologic behavior, and management. Ann Surg Oncol. 2000;7:705–12.CrossRefPubMed
54.
Yasui M, Tsujinaka T, Mori M, Takahashi T, Nakashima Y, Nishida T. Characteristics and prognosis of rectal gastrointestinal stromal tumors: an analysis of registry data. Surg Today. 2017;47:1188–94.CrossRefPubMed
55.
Baik SH, Kim NK, Lee CH, Lee KY, Sohn SK, Cho CH, et al. Gastrointestinal stromal tumor of the rectum: an analysis of seven cases. Surg Today. 2007;37:455–9.CrossRefPubMed
Metadaten
Titel
Neoadjuvant imatinib therapy in rectal gastrointestinal stromal tumors
verfasst von
Manabu Kaneko
Shigenobu Emoto
Koji Murono
Hirofumi Sonoda
Masaya Hiyoshi
Kazuhito Sasaki
Yasutaka Shuno
Takeshi Nishikawa
Toshiaki Tanaka
Keisuke Hata
Kazushige Kawai
Hiroaki Nozawa
Publikationsdatum
15.11.2018
Verlag
Springer Singapore
Erschienen in
Surgery Today / Ausgabe 6/2019
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-018-1737-5

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