Imatinib plasma monitoring-guided dose modification for managing imatinib-related toxicities in gastrointestinal stromal tumor patients

J Korean Med Sci. 2013 Aug;28(8):1248-52. doi: 10.3346/jkms.2013.28.8.1248. Epub 2013 Jul 31.

Abstract

Imatinib, the first-line treatment in patients with advanced gastrointestinal stromal tumors (GIST), is generally well tolerated, although some patients have difficulty tolerating the standard dose of 400 mg/day. Adjusting imatinib dosage by plasma level monitoring may facilitate management of patients who experience intolerable toxicities due to overexposure to the drug. We present two cases of advanced GIST patients in whom we managed imatinib-related toxicities through dose modifications guided by imatinib plasma level monitoring. Imatinib blood level testing may be a promising approach for fine-tuning imatinib dosage for better tolerability and optimal clinical outcomes in patients with advanced GIST.

Keywords: Dose-Modification; Gastrointestinal Stromal Tumors (GIST); Imatinib; Imatinib Plasma Monitoring.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antineoplastic Agents / blood
  • Antineoplastic Agents / therapeutic use*
  • Benzamides / blood
  • Benzamides / therapeutic use*
  • Drug Monitoring
  • Exons
  • Gastrointestinal Neoplasms / diagnostic imaging
  • Gastrointestinal Neoplasms / drug therapy*
  • Gastrointestinal Neoplasms / pathology
  • Gastrointestinal Stromal Tumors / diagnostic imaging
  • Gastrointestinal Stromal Tumors / drug therapy*
  • Gastrointestinal Stromal Tumors / pathology
  • Humans
  • Imatinib Mesylate
  • Liver Neoplasms / secondary
  • Male
  • Mutation
  • Piperazines / blood
  • Piperazines / therapeutic use*
  • Positron-Emission Tomography
  • Proto-Oncogene Proteins c-kit / genetics
  • Pyrimidines / blood
  • Pyrimidines / therapeutic use*
  • Tomography, X-Ray Computed

Substances

  • Antineoplastic Agents
  • Benzamides
  • Piperazines
  • Pyrimidines
  • Imatinib Mesylate
  • Proto-Oncogene Proteins c-kit