Clinical update on adult and pediatric gastrointestinal stromal tumor:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia, PA
Saunders
2009
|
| Series: | Hematology, oncology clinics of North America
23,1 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XIV, 158 S. Ill., graph. Darst. 24 cm |
| ISBN: | 9781437704860 1437704867 |
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| adam_text | Clinical Update on Adult and
Pediatrie
Gastrointestinal Stromal Tumor
Contents
Preface
x¡¡¡
Jonathan C. Trent and Shreyaskumar R.
Patel
Inherited Predisposition to Gastrointestinal Stromal Tumor
1
Rinki Agarwal and Mark Robson
Gastrointestinal stromal tumors (GIST) are the most common mesenchy-
mal tumors of the gastrointestinal tract and are a relatively recently identi¬
fied category of mesenchymal tumors. Germline mutations in a number of
different genes predispose to GIST. This article discusses familial GIST
syndrome, Carney triad, Carney-Stratakis syndrome, and neurofibromato-
sis type
1,
and addresses the recognition of an inherited predisposition in
GIST patients.
Pediatric
Gastrointestinal StromalTumors
15
Alberto S.
Pappo
and
Katherine
A. Janeway
Gastrointestinal stromal tumors (GISTs) rarely occur in
pediatric
patients,
but increased recognition of adult GIST has led to better awareness of
the existence of this entity in the
pediatric
population. GIST occurring in
pediatrìe
patients has a unique biology and clinical behavior and warrants
discussion as an independent entity. The generally accepted definition of
pediatrie
GIST is a tumor that is diagnosed at the age of
18
years or youn¬
ger. This review highlights the clinical features, molecular biology, and clin¬
ical management of this rare
pediatrie
entity.
Imaging of Gastrointestinal StromalTumors and Assessment of Benefit
from SystemicTherapy
35
Piyaporn Boonsirikamchai, Donald A. Podoloff, and Haesun Choi
While gastrointestinal stromai tumors have been increasingly recognized
with the prolonged survival and highly effective new targeted treatments,
the role of imaging has become important not only for diagnosing and
staging the tumors, but also for monitoring the effects of treatment and
surveillance. Computed tomography is the imaging modality of choice
for these purposes. Fluorine-18 fluorodeoxyglucose positron emission to¬
mography is primarily used in problem solving when there are inconsis¬
tencies between CT and clinical findings or inconclusive CT images. The
roles of MR! and ultrasound are also described.
Contemporary Pathology of Gastrointestinal Stromal Tumors
49
Bernadette
Lieg!,
Jason
L
Homick, and Alexander J.F.
Lazar
Gastrointestinal stromal tumors (GISTs) are the most common mesenchy¬
mal tumors of
Ле
gastrointestinal tract. The vast majority of GISTs harbor
a KIT or PDGFRA mutation and express KIT by immunohistochemistry.
viii
Contents
However, KIT-negative tumors and tumors showing unusual morphologic
features can cause major diagnostic problems. The ability to inhibit the
active KIT or PDGFRA kinase with tyrosine kinase inhibitors and alternative
drugs demands more than ever accurate tumor classification and risk as¬
sessment. This article focuses on the pathology of GIST, including unusual
variants and morphologic changes resulting from treatment. Parameters
for risk assessment, potentially helpful new immunohistochemical
markers, differential diagnosis, and the application of molecular classifica¬
tion schemes are discussed.
Gastrointestinal Stromal Tumor: A Clinical Overview
69
Richard Quek and Suzanne George
Gastrointestinal stromal tumor (GIST) is a disease that was poorly under¬
stood historically. In the last decade, it has undergone a major transforma¬
tion, sparked by the landmark discovery of the central role of activating KIT
mutations in its pathogenesis and recognition of KIT protein expression
(CD
117)
as a reliable diagnostic marker of disease. The introduction
and subsequent US Food and Drug administration approval of imatinib
mesylate in the treatment of metastatic or unresectable GIST in February
1, 2002
has thrust this hitherto little known disease into the center stage
of oncology, and GIST has served as a model for rationally designed
drug trials in the field of cancer therapeutics since.
Management of Resectable Gastrointestinal Stromal Tumor
79
Umer I. Chaudhry and Ronald P. DeMatteo
Gastrointestinal stromal tumor (GIST)
¡s a
rare neoplasm that recently has
become an intense focus of scientific investigation, as it serves as a model
for the molecular therapy for cancer. Although surgery remains the princi¬
ple treatment of primary localized GIST, imatinib mesylate, a selective in¬
hibitor of KIT protein, achieves dramatic responses in metastatic GIST.
Multimodality therapy integrating surgery and molecular therapy has
shown promise. This article summarizes the epidemiology, clinicopatho-
logic features, natural history, and clinical management of GIST.
Cardiovascular Effects of Tyrosine Kinase Inhibitors Used for Gastrointestinal
Stromal Tumors
97
Vishnu Chintalgattu, Shalin S.
Patel,
and Aarif Y. Khakoo
Small-molecule tyrosine kinase inhibitors (TKIs) have revolutionized the
targeted treatment of various cancers, including gastrointestinal stromal
tumors (GISTs). Recent evidence suggests the possibility of cardiotoxicity
secondary to TKI treatment of GISTs. Preclinical studies indicate that im¬
atinib and sunitinib may be directly toxic to cardiac myocytes. Clinically,
cardiotoxicity attributable to imatinib seems to be infrequent and manage¬
able, whereas that attributable to sunftinib is more common and more
severe. Further prospective studies with objective cardiac monitoring
and long-term follow up are needed to define more accurately the
Contents
¡χ
incidence,
natural
history, and risk factors for developing cardiotoxicity as¬
sociated with TKIs used in the treatment of patients who have GISTs. In
this review, the authors discuss what is known regarding the cardiovascu¬
lar effects of TKIs used in the treatment of GISTs.
Ocular Side Effects Associated with imatinib Mesylate and Perifosine
for Gastrointestinal Stromal Tumor
109
S.
Serdar Dogan
and
Bita Esmaeli
Imatinib mesylate and perifosine are two relatively new drugs that have im¬
proved outcomes for patients with gastrointestinal stromal tumors in re¬
cent years. The ocular side effects of these two drugs are discussed in
this chapter. The most common ocular side effect associated with imatinib
mesylate is
periorbital
edema. Perifosine has been associated with a
ring-shaped perilimbal
corneal
ulcération
that can be treated with topical
steroids and topical antibiotics.
Hepatic Resection for Gastrointestinal Stromal Tumor Liver
Métastases
115
Stephane
Zalinski, Martin Palavecino, and Eddie K. Abdalla
Liver resection is the preferred treatment for gastrointestinal stromal tumor
liver
métastases
(GIST LMs) when complete resection can be achieved.
Major and extended hepatic resections can be safely performed, and us¬
ing modem techniques, an increasing proportion of patients with GIST
LMs are candidates for potentially curative therapy. The combination of
tyrosine kinase inhibitor therapy (eg, imatinib) with surgery seems to im¬
prove outcome, and although prospective data are lacking, a short neoad-
juvant course
(6
months) of imatinib therapy followed by resection may
improve patient selection for surgery and outcome from treatment. Post¬
operative therapy with imatinib is generally advised, although the duration
of such therapy is not yet clearly defined. These questions may formulate
the basis for future prospective studies of imatinib with complete resection
of GIST LMs.
Gastrointestinal Stromal Tumor: Role of Interventional Radiology in Diagnosis
and Treatment
129
Rony Avritscher
and Sanjay Gupta
Gastrointestinal stromal tumors (GISTs) are the most common mesenchy-
mal neoplasm of the gastrointestinal tract. The interventional radiologist
plays an important role in the diagnosis and locoregional therapy for
metastatic GISTs. Radiofrequency ablation
(RFA)
is a potentially curative
option for patients exhibiting partial response to imatinib with focal residual
disease.
RFA
can also be used for local control of focal hepatic or perito¬
neal metastasis. Hepatic embolization or chemoembolization is reserved
for the treatment of progressive liver disease in imatinib-resistant patients
who are not suitable for sunitinib as a second-line therapy.
Contents
New
Therapeutic Approaches for
Advanced
Gastrointestinal StromaiTumors
139
Neeta Somaiah and Margaret
von Mehren
The management of advanced gastronintestinal stromal tumor is increas¬
ingly complex because of imatinib refractory disease. Primary resistance
to imatinib is uncommon, and most patients progress after development
of additional genetic changes. This article reviews management strategies
including surgical approaches, local modalities for progressive liver
métastases, as
well as novel therapeutic agents.
Index
151
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| spelling | Clinical update on adult and pediatric gastrointestinal stromal tumor guest eds.: Jonathan C. Trent ... Philadelphia, PA Saunders 2009 XIV, 158 S. Ill., graph. Darst. 24 cm txt rdacontent n rdamedia nc rdacarrier Hematology, oncology clinics of North America 23,1 Gastro-enterologie gtt Stroma gtt Tumoren gtt Gastrointestinaler Tumor (DE-588)4224415-8 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Gastrointestinaler Tumor (DE-588)4224415-8 s b DE-604 Trent, Jonathan C. Sonstige (DE-588)137874588 oth Hematology, oncology clinics of North America 23,1 (DE-604)BV000625446 23,1 Digitalisierung UB Regensburg application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017349475&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Clinical update on adult and pediatric gastrointestinal stromal tumor |
| title_auth | Clinical update on adult and pediatric gastrointestinal stromal tumor |
| title_exact_search | Clinical update on adult and pediatric gastrointestinal stromal tumor |
| title_full | Clinical update on adult and pediatric gastrointestinal stromal tumor guest eds.: Jonathan C. Trent ... |
| title_fullStr | Clinical update on adult and pediatric gastrointestinal stromal tumor guest eds.: Jonathan C. Trent ... |
| title_full_unstemmed | Clinical update on adult and pediatric gastrointestinal stromal tumor guest eds.: Jonathan C. Trent ... |
| title_short | Clinical update on adult and pediatric gastrointestinal stromal tumor |
| title_sort | clinical update on adult and pediatric gastrointestinal stromal tumor |
| topic | Gastro-enterologie gtt Stroma gtt Tumoren gtt Gastrointestinaler Tumor (DE-588)4224415-8 gnd |
| topic_facet | Gastro-enterologie Stroma Tumoren Gastrointestinaler Tumor Aufsatzsammlung |
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