Der Gastroenterologe

, Volume 7, Issue 1, pp 30–36 | Cite as

Mutationsbasierter Therapiealgorithmus bei gastrointestinalen Stromatumoren

Hat die c-Kit/PDGFRA-Mutationsanalyse Einfluss auf Therapieentscheidungen?
Schwerpunkt
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Zusammenfassung

Bei gastrointestinalen Stromatumoren finden sich in mindestens 85% der Fälle aktivierende Mutationen der Stammzellfaktor-Rezeptortyrosinkinase (c-Kit) oder des „platelet-derived growth factor Receptor α“ (PDGFRA). Die Therapieoptionen beinhalten neben Operation und lokalen Therapieverfahren eine systemische Therapie mit Tyrosinkinaseinhibitoren wie Imatinib oder Sunitinib. Die Systemtherapie wird eingesetzt in der neoadjuvanten, adjuvanten und metastasierten Situation. Die Kenntnis des individuellen Mutationsstatus erlaubt dabei eine Vorhersage des Ansprechens auf die Primärtherapie, und kann bei Progredienz unter der Primärtherapie ein Entscheidungskriterium für die Auswahl der Zweitlinientherapie darstellen.

Schlüsselwörter

Gastrointestinale Stromatumoren (GIST) Stammzellfaktor-Rezeptortyrosinkinase (c-KitPlättchenwachstumsfaktor-Rezeptor α (PDGFRATyrosinkinaseinhibitor Resistenz 

Mutational status based therapy algorithm for gastrointestinal stroma tumors

Does c-Kit/PDGFRA mutational analysis affect treatment decisions?

Abstract

Activating mutations of the stem cell factor receptor tyrosine kinase (c-Kit) or platelet-derived growth factor receptor α (PDGFRA) can be found in at least 85% of cases of gastrointestinal stromal tumors. The therapeutic options include surgery, local treatment and systemic treatment with tyrosine kinase inhibitors, such as imatinib or sunitinib. Kinase inhibitor-based treatment is used in neoadjuvant, adjuvant and metastatic settings. Knowledge of the individual mutational status allows prediction of response to first-line medical treatment and provides information which can guide selection of the appropriate second-line therapy.

Keywords

Stromal tumors, gastrointestinal (GIST) Stem cell factor receptor tyrosine kinase (c-KitPlatelet-derived growth factor receptor α (PDGFRATyrosine kinase inhibitor Drug resistance 

Notes

Interessenkonflikt

Der Autor gibt an, dass kein Interessenkonflikt besteht.

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© Springer-Verlag 2012

Authors and Affiliations

  1. 1.III. Medizinische Klinik und Poliklinik, Klinikum rechts der IsarTechnische Universität MünchenMünchenDeutschland

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