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01-01-2011 | Supplement (Special Issue)

Mechanisms of resistance to imatinib and sunitinib in gastrointestinal stromal tumor

Authors: Wei-Lien Wang, Anthony Conley, David Reynoso, Laura Nolden, Alexander J. Lazar, Suzanne George, Jonathan C. Trent

Published in: Cancer Chemotherapy and Pharmacology | Special Issue 1/2011

Abstract

Gastrointestinal stromal tumor (GIST), the most common mesenchymal neoplasm of the GI tract and one of the most common sarcomas, is dependent on the expression of the mutated KIT or platelet-derived growth factor receptor in most cases. Imatinib mesylate potently abrogates the effects of KIT signaling by directly binding into the ATP-binding pocket of the kinase. It is becoming increasingly apparent that the binding affinity of imatinib for the receptor is dependent on the type and location of mutation. Within KIT, patients whose tumor has an exon 9 mutation are treated by many clinicians with higher doses of imatinib than those patients with mutations within exon 11. Additionally, there are over 400 unique mutations within exon 11 that may have distinctly different binding affinity for imatinib as well as other kinases. Secondary KIT mutations generally occur at a codon where imatinib binds resulting in KIT reactivation and resistance. Sunitinib malate, a second-generation KIT inhibitor is active in imatinib-resistant disease and is FDA-approved for use in this setting. In this review, we describe the biology of the genes and gene mutations responsible for GIST and discuss known and potential clinical implications.

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Title: Mechanisms of resistance to imatinib and sunitinib in gastrointestinal stromal tumor
Authors: Wei-Lien Wang
Anthony Conley
David Reynoso
Laura Nolden
Alexander J. Lazar
Suzanne George
Jonathan C. Trent
Publication date: 01-01-2011
Publisher: Springer-Verlag
Published in: Cancer Chemotherapy and Pharmacology / Issue Special Issue 1/2011
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-010-1513-8

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