Complete response to sunitinib for more than three years in a patient with a jejunum gastrointestinal stromal tumor: A case report

Medicine (Baltimore). 2019 Jan;98(3):e14060. doi: 10.1097/MD.0000000000014060.

Abstract

Rationale: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract and is characterized by KIT mutations. Patientsresistant to 1st-line imatinib therapy are usually given sunitinib assecond-line treatment, which provides a median progression-free survival of 8 to 12 months. We report the 1st case of metastatic jejunum GIST with a KIT exon 11 deletion that showed complete response (CR) to sunitinib for more than 3 years.

Patient concerns: A 34-year-old man with advanced jejunum GIST was surgically treated upon initial diagnosis, and was histologically found to carry a high recurrence risk. Genetic testing revealed a KIT exon 11 deletion, and adjuvant therapy with imatinib was administered. The imatinib dose was escalated following recurrence in the abdomen, but the mass continued to grow.

Diagnosis: He was diagnosed with abdominal recurrence of GIST based on his medical history and histopathological results.

Intervention: Second-line sunitinib therapy was given.

Outcomes: The mass disappeared, and CR was seen following 7 months of sunitinib therapy; this CR was sustained for more than 45 months.

Lessons: In cases of metastatic jejunum GIST with a KIT exon 11 deletion, sunitinib as second-line therapy can be used to achieve CR for more than 3 years.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents / administration & dosage*
  • Drug Administration Schedule
  • Drug Resistance, Neoplasm / drug effects
  • Drug Resistance, Neoplasm / genetics
  • Exons
  • Gastrointestinal Stromal Tumors / drug therapy*
  • Gastrointestinal Stromal Tumors / genetics
  • Humans
  • Induction Chemotherapy
  • Jejunal Neoplasms / drug therapy*
  • Jejunal Neoplasms / genetics
  • Male
  • Mutation
  • Proto-Oncogene Proteins c-kit / drug effects
  • Proto-Oncogene Proteins c-kit / genetics
  • Sunitinib / administration & dosage*
  • Time Factors
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • KIT protein, human
  • Proto-Oncogene Proteins c-kit
  • Sunitinib