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Complete response of gastrointestinal stromal tumor liver metastases to regorafenib

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Abstract

Imatinib, sunitinib, and regorafenib show high disease control rates for metastatic or unresectable gastrointestinal stromal tumor. However, partial response rates are low, and complete response to regorafenib had not been reported. Our case was an 81-year-old woman who underwent partial gastrectomy for an extremely large high risk gastrointestinal stromal tumor. Adjuvant imatinib caused intolerable adverse effects. One year after the surgery, local recurrence was diagnosed and sunitinib was started. Sunitinib also caused severe adverse effects. However, long-term disease control for 39 months was achieved with adequate dose reduction. After that period, the local recurrence started to grow rapidly, and the patient underwent total gastrectomy and distal pancreatectomy with excisions of nearby seeding nodules. Six months after the second operation, two liver metastasis nodules and one peritoneal metastasis nodule were found. We started regorafenib at standard dose. One month after the start of regorafenib treatment, the dose was reduced as follows: 2 weeks administration of 80 mg per day followed by 2 weeks drug holiday, due to intolerable adverse effects. The evaluation computed tomography and 18F-Fluorodeoxyglucose positron emission tomography could confirm complete response of her liver metastases. Even low dose regorafenib could maintain complete response for 10 months with only mild adverse effect. We report the first case of clinical complete response by regorafenib against liver metastases of gastrointestinal stromal tumor with intolerance to imatinib and refractory to sunitinib.

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Acknowledgments

The authors thank Dr. Tobioka, Department of pathological diagnosis, Otaru Kyokai Hospital for evaluating histopathological findings.

Conflict of interest

All of the authors, except one, declare that they have no conflict of interest. One (Yasushi Tsuji) has received lecture fees from Ono Pharmaceutical Co., Ltd.

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Authors and Affiliations

  1. Department of Medical Oncology, Tonan Hospital, Kita 1 Jo Nishi 6 Chome, Chuo-ku, Sapporo, 060-0001, Hokkaido, Japan

    Hiromitsu Kitayama, Junko Sugiyama, Tomohiro Kondo & Yasushi Tsuji

  2. Department of Gastroenterology, Tonan Hospital, Sapporo, Japan

    Michiaki Hirayama

  3. Department of Pathological Diagnosis, Tonan Hospital, Sapporo, Japan

    Yumiko Oyamada

  4. Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine, Sapporo, Japan

    Sho Takahashi

Authors
  1. Hiromitsu Kitayama
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  2. Michiaki Hirayama
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  3. Junko Sugiyama
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  4. Tomohiro Kondo
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  5. Yumiko Oyamada
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  6. Sho Takahashi
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  7. Yasushi Tsuji
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Correspondence to Hiromitsu Kitayama.

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Kitayama, H., Hirayama, M., Sugiyama, J. et al. Complete response of gastrointestinal stromal tumor liver metastases to regorafenib. Int Canc Conf J 4, 167–171 (2015). https://doi.org/10.1007/s13691-014-0192-4

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  • DOI: https://doi.org/10.1007/s13691-014-0192-4

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