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buy cheap accutane / cheap accutane 40 mg / Tratamiento Regorafenib para refractarios tumores del estroma gastrointestinal avanzados

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Sub-categoría:

tumores del estroma gastrointestinal (GIST)

Categoría:

Sarcoma

Reunión:

Reunión Anual de ASCO 2014

Resumen N º:

10551

Citación:

J Clin Oncol 32:5 s, 2014 (suppl; abstr 10551)

Autor (s): Marco Maruzzo, Attila Kollar, Charlotte Benson, Christina mesiú, Elizabeth Cartwright, Beatrice M. Seddon, Palma Dileo, Aisha Miah, Juan Martin-Liberal, Khin Thway, Ellen McGrath, Alison Dunlop, Ian Robert Judson, Mark David Linch; Unidad del sarcoma, del Royal Marsden Hospital, Londres, Reino Unido; Oncología Médica Inselspital Bern, Berna, Suiza; Unidad del sarcoma, el Royal Marsden NHS Foundation Trust, Londres, Reino Unido; University College London Hospitals NHS Foundation Trust, Londres, Reino Unido; El Royal Marsden NHS Foundation Trust, Londres, Reino Unido; El Royal Marsden Hospital, Sutton, Reino Unido

Resumen:

Antecedentes:

Los inhibidores de la tirosina cinasa (TKI) han revolucionado el tratamiento de los tumores del estroma gastrointestinal (GIST), aunque la mayoría de los pacientes desarrollan resistencia a la primera y segunda línea de terapias. Regorafenib, una exposición oral TKI multi-objetivo, ha demostrado beneficio en pacientes con GIST tratados previamente.

Métodos:

Se evaluó la seguridad y la actividad preliminar de regorafenib en los pacientes tratados en el Programa de Acceso Gestionado (MAP). Todos los pacientes consecutivos con GIST avanzado que habían progresado durante o eran intolerantes a imatinib y sunitinib fueron reclutados en el Hospital Royal Marsden Hospital University College. Revisamos retrospectivamente los datos de respuesta, la toxicidad y la duración del tratamiento. La respuesta se evaluó por RECIST y criterios Choi. La toxicidad fue clasificado de acuerdo a los criterios de CTCAE v4.0.

Resultados:

20 pacientes fueron incluidos en el MAP en el Reino Unido entre 3/2013 y 9/2013. La media de edad fue de 68 (rango 45-87), 65% de los pacientes eran hombres. Estado funcional fue 0-1 para los 18 pacientes (90%), 2 de 2 pacientes (10%). La duración media del tratamiento fue de 29 semanas (rango 1-50). 18 pacientes fueron evaluables para la respuesta y todos los pacientes alcanzaron una mejor respuesta de la enfermedad al menos estable. Con una media de seguimiento de 6,7 meses, no hubo 2 respuestas parciales (11%) por RECIST y 7 respuestas parciales (39%) de acuerdo con los criterios de Choi. Un paciente que tenía un PR en regorafenib no se había beneficiado de sunitinib anterior. 3 pacientes presentaron progresión de la enfermedad y 3 pacientes interrumpieron el tratamiento debido a las toxicidades inaceptables; fistulización, mialgia y fatiga. 10 (50%) pacientes tuvieron toxicidades grado 3 y 11 (55%) pacientes requirieron una reducción de la dosis. 5 pacientes comenzaron a la dosis reducida debido a la toxicidad TKI significativa anterior, sin embargo 2 pacientes pudieron ser dosis escalada. La media de la SLP (Supervivencia Libre de Progresión) y la SG (Supervivencia Global) aún no se han alcanzado, pero sobre todo, una enfermedad estable prolongada se observó en 1 paciente con mutación exón 9 y 1 paciente con mutación D842V PDGFR.

Conclusiones:

Estos datos demuestran que se debe fomentar la actividad de regorafenib en la práctica clínica habitual. Los eventos adversos documentados están en línea con los datos de ensayos anteriores

Fuente:

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