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Various toxicities: case report An elderly man in his 70s [exact age not stated] developed interstitial pneumonia, nephrotoxicity, creatinine increased and proteinuria during treatment with imatinib, regorafenib or sunitinib for gastric gastrointestinal stromal tumours (GIST) [routes not stated; not all duration of treatments to reaction onsets and outcomes stated]. The man, who was diagnosed with gastric GIST with peritoneal dissemination, started receiving chemotherapy with imatinib 400 mg/day. However, one month following the introduction of imatinib, he developed grade 4 interstitial pneumonia that required hospitalisation. The man’s therapy with imatinib was discontinued. After the interstitial pneumonia ameliorated, he underwent partial gastrectomy, splenectomy and partial transverse colectomy, and both lesions were radically resected. He was initiated on sunitinib 50 mg/day due to recurrent GIST in the second month following the initial surgery. Subsequently, he developed nephrotoxicity, and the dose of sunitinib was further reduced to 25 mg/day. However, at 29 months following the surgery, a grade 3 creatinine increased was observed, leading to discontinuation of sunitinib. A CT scan performed at 32 months post-operation revealed a 3cm peritoneal dissemination in the inferior margin of the pancreas. Although, sunitinib was restarted at the same dose of 25 mg/day as before the cessation, his tumour increased to 5.1cm. Hence, regorafenib 120 mg/day was initiated. Following the initiation of regorafenib, the tumour size reduced; however, he developed renal toxicity. The dose of regorafenib was reduced to 80 mg/day, but 16 months after the induction, he experienced grade 3 creatinine increase and grade 3 proteinuria. Thus, regorafenib was stopped. One month following the drug discontinuation, tumour regrowth was noted. He then underwent resection of the left adrenal gland and resection of the pancreatic body. After the surgery, regorafenib was resumed at a reduced dose of 80 mg/day. Thereafter, no tumour recurrence was observed. Kado T, et al. [A Case of Multidisciplinary Treatment for a Recurrent Gastrointestinal Stromal Tumor of the Stomach]. Gan to Kagaku Ryoho 47: 334-336, No. 2, Feb 2020. 803498996 Available from: URL: https://pubmed.ncbi.nlm.nih.gov/32381980/ [Japanese; summarised from a translation]

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Reactions 29 Aug 2020 No. 1819